Provider Demographics
NPI:1831159458
Name:LEMONS, MARK FRANCIS (MD FACEP)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:FRANCIS
Last Name:LEMONS
Suffix:
Gender:M
Credentials:MD FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-243-6040
Mailing Address - Fax:617-243-6924
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-243-6040
Practice Address - Fax:617-243-6924
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54537207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3017061Medicaid
J06090OtherBLUE SHIELD
3900199OtherUNITED
438976OtherHP
054537OtherTUFTS
J06090Medicare ID - Type Unspecified
054537OtherTUFTS