Lemoine, Tara Jackson

Lemoine, Tara Jackson is an individual health care provider with primary practice located at 1906 Belleview Ave Se , Roanoke VA 24014-1838. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Lemoine, Tara Jackson can be contacted via phone (540) 224-4635.

Contact Information

Primary practice address
1906 Belleview Ave Se Roanoke VA 24014-1838
Phone: (540) 224-4635
Fax: (540) 985-9099
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0102208200 Virginia

Profile Details

NPI number 1669669412
LBN Legal business name Lemoine, Tara Jackson
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2007
Last updated Oct 19th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1669669412 NPPES
Georgia Other 618879 WELLCARE
Georgia MEDICAID GA1252 WELLCARE
Georgia MEDICAID 003111892A WELLCARE
Georgia Other P00999566 WELLCARE

Popular Providers