Healthcare Provider Details

I. General information

NPI: 1952980559
Provider Name (Legal Business Name): BYRON S LEMON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15810 S 45TH ST STE 190
PHOENIX AZ
85048-7697
US

IV. Provider business mailing address

3235 E BONANZA RD
GILBERT AZ
85297-9307
US

V. Phone/Fax

Practice location:
  • Phone: 480-378-0485
  • Fax: 480-598-1458
Mailing address:
  • Phone: 916-215-2853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number001121
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: