MEDICARE: JAMES LEE MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	45206	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LEL45206	OTHER		BLUE CROSS
2	808898	OTHER		GROUP PTAN

General Provider Information

NPI Number	:	1144427899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES LEE MD PC

Provider Business Mailing Address
First Line	:	8580 SCARBOROUGH DR
Second Line	:	SUITE 125
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7502
Country	:	US
Telephone Number	:	719-282-1211
Fax Number	:	719-282-1247

Provider Business Practice Location Address
First Line	:	8580 SCARBOROUGH DR
Second Line	:	SUITE 125
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7502
Country	:	US
Telephone Number	:	719-282-1211
Fax Number	:	719-282-1247

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES H LEE
Credential	:	MD
Telephone Number	:	719-282-1211

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	10/28/2011

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