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General NPI Number Information
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NPI Number | 1902964455
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Entity Type | Organization
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Legal Business Name | F A MCGOWAN & R D LEE
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 115 CLIFTON AVE
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City | COLLINGDALE
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State | PA
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Zip | 19023-3809
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Country | US
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Telephone | 610-586-1919
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Fax | 610-586-6947
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Provider Business Mailing Address
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Address Line | 115 CLIFTON AVE
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City | COLLINGDALE
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State | PA
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Zip | 19023-3809
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Country | US
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Telephone | 610-586-1919
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Fax | 610-586-6947
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. REGINALD DONALD LEE
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Credential | D. O.
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Telephone | 610-586-1919
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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 | OS006159-L
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License Number State | PA
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