Healthcare Provider Details

I. General information

NPI: 1801373055
Provider Name (Legal Business Name): LEE JOHN BIZON JR. FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GENERAL LEONARD WOOD COMMUNITY HOSPITAL 4234 ILLINOIS AVE
FORT LEONARD WOOD MO
65473-9098
US

IV. Provider business mailing address

GENERAL LEONARD WOOD COMMUNITY HOSPITAL 4234 ILLINOIS AVE
FORT LEONARD WOOD MO
65473-9098
US

V. Phone/Fax

Practice location:
  • Phone: 573-596-1490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0132512
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: