Provider Demographics
NPI:1033184619
Name:LEMON, RON E (DC)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:E
Last Name:LEMON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 VINEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-2952
Mailing Address - Country:US
Mailing Address - Phone:478-330-5087
Mailing Address - Fax:478-330-5087
Practice Address - Street 1:2440 VINEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2952
Practice Address - Country:US
Practice Address - Phone:478-330-5087
Practice Address - Fax:478-330-5087
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 002737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCBTQMedicare PIN
U21168Medicare UPIN