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General NPI Number Information
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NPI Number | 1861498578
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Entity Type | Individual
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Provider Name | LEE M UGOL MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 9250 N 3RD ST STE. 3010
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City | PHOENIX
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State | AZ
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Zip | 85020-2437
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Country | US
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Telephone | 602-861-1168
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Fax | 602-861-1763
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Provider Business Mailing Address
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Address Line | 2500 W UTOPIA RD STE. 100
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City | PHOENIX
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State | AZ
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Zip | 85027-4171
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Country | US
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Telephone | 623-434-6200
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Fax | 623-780-3752
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 21873
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License Number State | AZ
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