Healthcare Provider Details

I. General information

NPI: 1639168875
Provider Name (Legal Business Name): DOUGLAS E. LEMLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6112 LINDLEY WOODS DR
GREENSBORO NC
27410-4979
US

IV. Provider business mailing address

6112 LINDLEY WOODS DR
GREENSBORO NC
27410-4979
US

V. Phone/Fax

Practice location:
  • Phone: 336-855-7553
  • Fax: 336-855-7553
Mailing address:
  • Phone: 336-855-7553
  • Fax: 336-855-7553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number31164
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number38530
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number31886
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number101235754
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME89882
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number53932
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number38530
License Number StateKY
# 8
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number31164
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number61623
License Number StateOH
# 10
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD423244
License Number StatePA
# 11
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number21433
License Number StateWV
# 12
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number31886
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: