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Individual

DR. RONALD SAMUEL LEMON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2490 CENTRAL AVE, LAKE STATION, IN 46405-2122
(219) 763-8112
(219) 764-3251
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-3251

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
046-009316
IL
152W00000X
Optometrist
Primary
18003034A
IN

Other

Enumeration date
11/28/2006
Last updated
12/15/2014
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