MEDICARE: JOANN K LEE MD

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
1	207Q00000X	Family Medicine Physician	47106	WI

General Provider Information

NPI Number	:	1710946728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN K LEE MD

Provider Business Mailing Address
First Line	:	1251 ELBOWOODS LOOP
Second Line	:
City	:	NEW TOWN
State	:	ND
Zip	:	58763
Country	:	US
Telephone Number	:	701-627-4750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 ELBOWOODS LOOP
Second Line	:
City	:	NEW TOWN
State	:	ND
Zip	:	58763-9112
Country	:	US
Telephone Number	:	701-627-4750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	04/14/2025

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