Healthcare Provider Details
I. General information
NPI: 1497702625
Provider Name (Legal Business Name): JOAN B LEHMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/31/2006
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4427 EMERSON ST
JACKSONVILLE FL
32207-4969
US
IV. Provider business mailing address
2420 S HIGHWAY 29
CANTONMENT FL
32533-5808
US
V. Phone/Fax
- Phone: 904-398-7015
- Fax:
- Phone: 850-968-3565
- Fax: 850-968-3575
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | D0044261 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | ME132178 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: