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Individual

JIMMY V. LEMKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
447 N BELAIR RD STE 104, EVANS, GA 30809
(706) 854-2180
(706) 854-2189
Mailing address
PO BOX 1705, SUITE 4C, AUGUSTA, GA 30903-1705
(706) 774-7263
(706) 774-7230

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
016438
SC
207R00000X
Internal Medicine Physician
Primary
32421
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00453032D
GA
01
110102923
RAILROAD MEDICARE
01
11D0687551
CLIA # FOR GROUP
05
G32421
SC
Enumeration date
01/24/2007
Last updated
11/28/2018
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