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General NPI Number Information
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NPI Number | 1063405868
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Entity Type | Individual
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Provider Name | THOMAS H. LEE MD
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Gender | Male
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 10400 BLACKLICK EASTERN RD SUITE 110
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City | PICKERINGTON
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State | OH
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Zip | 43147-8235
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Country | US
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Telephone | 614-452-4540
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Fax | 877-992-6908
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Provider Business Mailing Address
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Address Line | 10400 BLACKLICK EASTERN RD SUITE 110
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City | PICKERINGTON
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State | OH
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Zip | 43147-8235
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Country | US
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Telephone | 614-452-4540
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Fax | 877-992-6908
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 35-06-4792
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License Number State | OH
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