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General NPI Number Information
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NPI Number | 1538110200
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Entity Type | Individual
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Provider Name | MARION O LEE JR. MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 910 N 5TH ST SUITE D
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City | CORDELE
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State | GA
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Zip | 31015-3254
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Country | US
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Telephone | 229-391-2910
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Fax | 229-386-4770
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Provider Business Mailing Address
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Address Line | 2773 MARSHALL DR
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City | TIFTON
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State | GA
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Zip | 31793-8101
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Country | US
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Telephone | 229-238-0121
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Fax | 229-238-0124
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 37596
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 37596
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License Number State | GA
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