Healthcare Provider Details

I. General information

NPI: 1598984254
Provider Name (Legal Business Name): JAMES TE-AN LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST HX316
LEXINGTON KY
40536-0293
US

IV. Provider business mailing address

800 ROSE ST HX316
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5069
  • Fax: 859-257-4457
Mailing address:
  • Phone: 859-323-2506
  • Fax: 859-257-4457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number44660
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR0935
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberN6454
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number44660
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberA 106825
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number44660
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: