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NPI Code Detail

MEDICARE: MARSHA V LEE M.D.

MEDICARE:   MARSHA V LEE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD26113TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14656078OTHERTNAETNA
23171381OTHERTNCIGNA
34052655OTHERTNBCBS, TN

General Provider Information

NPI Number : 1134112766
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHA V LEE M.D.
Provider Business Mailing Address
First Line : P.O. BOX 405827
Second Line :
City : ATLANTA
State : GA
Zip : 30384-5827
Country : US
Telephone Number : 901-226-3172
Fax Number : 901-226-3160
Provider Business Practice Location Address
First Line : 8950 HWY 64
Second Line : SUITE 116
City : LAKELAND
State : TN
Zip : 38002
Country : US
Telephone Number : 901-383-7170
Fax Number : 901-388-6478
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 05/24/2012

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