Provider Demographics
NPI:1467625921
Name:LEGACY PLASTIC SURGEONS
Entity Type:Organization
Organization Name:LEGACY PLASTIC SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-374-9100
Mailing Address - Street 1:300 LOCUST ST
Mailing Address - Street 2:STE 590
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1821
Mailing Address - Country:US
Mailing Address - Phone:330-374-9100
Mailing Address - Fax:330-374-9103
Practice Address - Street 1:300 LOCUST ST
Practice Address - Street 2:STE 590
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1821
Practice Address - Country:US
Practice Address - Phone:330-374-9100
Practice Address - Fax:330-374-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-05
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2821441Medicaid
OH2821441Medicaid