Individual
THEODORE L. LEMLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 REDROCK DR, REHOBOTH MCKINLEY CHRISTIAN HEALTH SERVICES, GALLUP, NM 87301-5682
(505) 863-7200
Mailing address
1901 REDROCK DR, PFS DEPT, GALLUP, NM 87301-5683
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2005-0621
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249012
—
AZ
01
—
NM009X31
BC/BS
NM
Enumeration date
01/24/2006
Last updated
07/09/2007
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