Provider Demographics
NPI:1427033562
Name:LEMMING, NICHOLAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:R
Last Name:LEMMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S PINE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2365
Mailing Address - Country:US
Mailing Address - Phone:812-524-3333
Mailing Address - Fax:812-524-3334
Practice Address - Street 1:225 S PINE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2365
Practice Address - Country:US
Practice Address - Phone:812-524-3333
Practice Address - Fax:812-524-3334
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054537207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000289380OtherBCBS
IN204770Medicare ID - Type Unspecified
IN000000289380OtherBCBS