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General NPI Number Information
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NPI Number | 1639670235
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Entity Type | Organization
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Legal Business Name | LEE WEISS MD, PLLC
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 20950 N TATUM BLVD STE 220
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City | PHOENIX
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State | AZ
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Zip | 85050-4252
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Country | US
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Telephone | 480-820-9140
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27643
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-0144
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Country | US
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Telephone | 602-318-6857
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | LINDA HAMELIN
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Credential |
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Telephone | 602-308-7817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 28896
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License Number State | AZ
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