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Individual

DR. KERMIT L LEMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
425 W GRAND RIVER AVE, WILLIAMSTON, MI 48895
(517) 655-2037
(517) 655-1983
Mailing address
425 W GRAND RIVER AVE, WILLIAMSTON, MI 48895
(517) 655-2037
(517) 655-1983

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002677
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0C36357
BCBSM
MI
01
200000025234
PHP
MI
05
5093639
MI
01
KL002677
STATE LICENCE NUMBER
MI
Enumeration date
10/03/2006
Last updated
09/11/2012
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