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General NPI Number Information
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NPI Number | 1467532929
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Entity Type | Individual
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Provider Name | JOHN W LEE MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 484 MESSENGER RD
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City | KEOKUK
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State | IA
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Zip | 52632-2115
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Country | US
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Telephone | 319-524-6311
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Fax | 319-524-0868
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Provider Business Mailing Address
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Address Line | 10 CARRIAGE GREEN EST
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City | KEOKUK
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State | IA
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Zip | 52632-2100
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Country | US
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Telephone | 319-524-6311
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Fax | 319-524-0868
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20680
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License Number State | IA
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