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General NPI Number Information
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NPI Number | 1255526307
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Entity Type | Organization
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Legal Business Name | TONY W LEE DO MEDICAL OFFICES, PLLC
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 908 WALLACE AVE SUITE 203
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City | LEITCHFIELD
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State | KY
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Zip | 42754-1479
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Country | US
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Telephone | 270-230-0111
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Fax | 270-230-0082
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Provider Business Mailing Address
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Address Line | 908 WALLACE AVE SUITE 203
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City | LEITCHFIELD
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State | KY
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Zip | 42754-1479
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Country | US
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Telephone | 270-230-0111
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Fax | 270-230-0082
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TONY WAI CHU LEE
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Credential | DO
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Telephone | 270-230-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 02900
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License Number State | KY
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