Provider Demographics
NPI:1831124569
Name:LEHMAN, MELISSA G (OD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:G
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1727 MARS HILL RD NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8090
Mailing Address - Country:US
Mailing Address - Phone:770-499-2005
Mailing Address - Fax:770-426-8303
Practice Address - Street 1:1727 MARS HILL RD NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-8090
Practice Address - Country:US
Practice Address - Phone:770-499-2005
Practice Address - Fax:770-426-8303
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002262152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA522979974AMedicaid
GA522979974AMedicaid
GAV10036Medicare UPIN