Provider Demographics
NPI:1518950591
Name:LEMMON, RUSSELL L (DO)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:L
Last Name:LEMMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3209 DRYDEN DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3015
Practice Address - Country:US
Practice Address - Phone:608-241-9020
Practice Address - Fax:608-241-1720
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI56850207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine