Basic Information
| Provider Information | |||||||||
| NPI: | 1598873499 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LENARDO | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 221 S 6TH ST | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478074214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122423005 | ||||||||
| FaxNumber: | 8122423054 | ||||||||
| Practice Location | |||||||||
| Address1: | 1725 N 5TH ST | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478044010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122423005 | ||||||||
| FaxNumber: | 8122424753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 01052358A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 0182863 | 01 | US DEPT OF LABOR | OTHER | 200280460 | 05 | IN | MEDICAID | 660003840 | 01 | RAILROAD MCARE PALAMETTO | OTHER | 200280460T | 05 | IN | MEDICAID | 351904269144 | 01 | CARESOURCE MEDICAID | OTHER | 434234 | 01 | HEALTHLINK | OTHER | 660002980 | 01 | RAILROAD MCARE PALAMETTO | OTHER | 000000089626 | 01 | ANTHEM | OTHER | 200280460B | 01 | IN | MOLINA HEALTHCARE MCAID | OTHER | 4024986 | 01 | CIGNA | OTHER | 7299112 | 01 | AETNA | OTHER | P00818720 | 01 | IN | RAILROAD MEDICARE | OTHER | N283320 | 01 | IN | HARMONY HEALTH PLAN IND | OTHER |