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NPI Code Detail

MEDICARE: DR. JAMES J LEE DO

MEDICARE: DR. JAMES J LEE DO
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
1207P00000XEmergency Medicine Physician04408KY
2207P00000XEmergency Medicine PhysicianOS 011041PA
3207P00000XEmergency Medicine Physician25MB08169500NJ
4208D00000XGeneral Practice Physician04408KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104408OTHERKYLICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306933114
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES J LEE DO
Provider Business Mailing Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : FORT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-539-9582
Fax Number :
Provider Business Practice Location Address
First Line : 1000 E MOUNTAIN BLVD
Second Line :
City : WILKES BARRE
State : PA
Zip : 18711-0027
Country : US
Telephone Number : 570-808-7762
Fax Number : 570-808-6128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 01/08/2026

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