Healthcare Provider Details

I. General information

NPI: 1801884689
Provider Name (Legal Business Name): MICHAEL LEMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 W WOOSTER ST RM 130
BOWLING GREEN OH
43402-2652
US

IV. Provider business mailing address

970 W WOOSTER ST RM 130
BOWLING GREEN OH
43402-2652
US

V. Phone/Fax

Practice location:
  • Phone: 419-352-6890
  • Fax:
Mailing address:
  • Phone: 419-352-6890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.054374
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35-054374
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: