Provider Demographics
NPI:1093185175
Name:LEMON TREE FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:LEMON TREE FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-351-8129
Mailing Address - Street 1:621 W.
Mailing Address - Street 2:
Mailing Address - City:DIMOND ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515
Mailing Address - Country:US
Mailing Address - Phone:907-351-8129
Mailing Address - Fax:331-442-4902
Practice Address - Street 1:621 W.
Practice Address - Street 2:
Practice Address - City:DIMOND ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515
Practice Address - Country:US
Practice Address - Phone:907-351-8129
Practice Address - Fax:331-442-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty