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General NPI Number Information
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NPI Number | 1447662325
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Entity Type | Individual
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Provider Name | LEE HOLDER DO
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Gender | Male
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 6095 GRAND MESA DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-3484
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Country | US
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Telephone | 719-980-1264
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Fax |
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Provider Business Mailing Address
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Address Line | 5955 ZEAMER AVE
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City | JBER
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State | AK
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Zip | 99506-3702
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Country | US
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Telephone | 907-580-6765
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OP60991132
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 149556
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License Number State | AK
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