Provider Demographics
NPI:1972695914
Name:LIME, JEFFREY M (MS PA C)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:LIME
Suffix:
Gender:M
Credentials:MS PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5605 W EUGIE
Mailing Address - Street 2:200
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1200
Mailing Address - Country:US
Mailing Address - Phone:602-843-2991
Mailing Address - Fax:602-978-1226
Practice Address - Street 1:5605 W EUGIE
Practice Address - Street 2:200
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1200
Practice Address - Country:US
Practice Address - Phone:602-843-2991
Practice Address - Fax:602-978-1226
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2206207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology