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General NPI Number Information
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NPI Number | 1497716377
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Entity Type | Individual
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Provider Name | VANESSA LEE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 3950 COBB PKWY NW STE 401
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City | ACWORTH
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State | GA
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Zip | 30101-9528
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Country | US
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Telephone | 404-857-9575
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 578
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City | LAGRANGE
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State | GA
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Zip | 30241-0010
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Country | US
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Telephone | 251-767-6378
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 025344
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29849
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 93527
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License Number State | GA
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