Healthcare Provider Details

I. General information

NPI: 1659301075
Provider Name (Legal Business Name): LEE F BURROUGHS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 ANDERSON FERRY RD
CINCINNATI OH
45238-4751
US

IV. Provider business mailing address

663 ANDERSON FERRY RD
CINCINNATI OH
45238-4751
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-8200
  • Fax: 513-347-0082
Mailing address:
  • Phone: 513-922-8200
  • Fax: 513-347-0082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-03-1740
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: