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NPI Code Detail

MEDICARE: WILLIAM P LEE O.D.

MEDICARE:   WILLIAM P LEE  O.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
1152W00000XOptometrist678TN

General Provider Information

NPI Number : 1700822046
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM P LEE O.D.
Provider Business Mailing Address
First Line : 7773 CHURCH ST
Second Line :
City : MILLINGTON
State : TN
Zip : 38053-2431
Country : US
Telephone Number : 901-872-3937
Fax Number : 901-872-3945
Provider Business Practice Location Address
First Line : 7773 CHURCH ST
Second Line :
City : MILLINGTON
State : TN
Zip : 38053-2431
Country : US
Telephone Number : 901-872-3937
Fax Number : 901-872-3945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 09/18/2009

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Directions to “ WILLIAM P LEE O.D.” Practice Location

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