1316938806 NPI number — EAR NOSE & THROAT FACIAL SUGERY CENTER PA

Table of content: DR. JAMES B. LEMMONS D.D.S. (NPI 1790810323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316938806 NPI number — EAR NOSE & THROAT FACIAL SUGERY CENTER PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EAR NOSE & THROAT FACIAL SUGERY CENTER PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316938806
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1726 MEDICAL BLVD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34110-1426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-594-7774
Provider Business Mailing Address Fax Number:
239-594-5974

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1726 MEDICAL BLVD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34110-1426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-594-7774
Provider Business Practice Location Address Fax Number:
239-594-5974
Provider Enumeration Date:
11/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MALIK
Authorized Official First Name:
CARILYN
Authorized Official Middle Name:
JUNE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
239-594-7774

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  ME86099 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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