Provider Demographics
NPI:1093710170
Name:LEMAIRE, TARA SPAIN (MD)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:SPAIN
Last Name:LEMAIRE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:751 STEWART ROAD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583
Mailing Address - Country:US
Mailing Address - Phone:931-256-1038
Mailing Address - Fax:931-614-7517
Practice Address - Street 1:1070 OLD NATIONAL PIKE ROAD
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:PA
Practice Address - Zip Code:15333-2114
Practice Address - Country:US
Practice Address - Phone:724-632-6801
Practice Address - Fax:724-632-6312
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2020-11-19
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Provider Licenses
StateLicense IDTaxonomies
TN0000030396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG88917Medicare UPIN