Healthcare Provider Details

I. General information

NPI: 1669580478
Provider Name (Legal Business Name): JAE YOUNG LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DRIVE UNIVERSITY OF IOWA HOSPITALS AND CLINICS
IOWA CITY IA
52242
US

IV. Provider business mailing address

200 HAWKINS DRIVE UNIVERSITY OF IOWA HOSPITALS AND CLINICS
IOWA CITY IA
52242
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-3375
  • Fax: 319-356-2220
Mailing address:
  • Phone: 319-356-3375
  • Fax: 319-356-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberSP181
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberSP181
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberSP181
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: