MEDICARE: THOMAS LEES OD

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	152W00000X	Optometrist	4901003021	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410003186	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	900G46508	OTHER	MI	BLUE CROSS PROVIDER

General Provider Information

NPI Number	:	1407842040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS LEES OD

Provider Business Mailing Address
First Line	:	1950 OLD GALLOWS RD STE 520
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3970
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	3957 24TH AVE
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-4102
Country	:	US
Telephone Number	:	810-984-5005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	03/05/2021

Similar Medicare Providers

1770503724 — DR. SCOTT DOUGLAS ALCOTT D.C.
Practice Location Address:

3941 24TH AVE
FORT GRATIOT, MI
48059-4102

Practice Phone: 810-985-6868
Practice Fax: 810-985-6991

1376565192 — DR. JOSEPH THOMAS TRUSKE DDS PC
Practice Location Address:

3901 24TH AVENUE
FORT GRATIOT, MI
48059-4102

Practice Phone: 810-984-1586
Practice Fax: 810-984-4789

1902941537 — DR. CAROL ALLEN OD
Practice Location Address:

3957 24TH AVE
FORT GRATIOT, MI
48059-4102

Practice Phone: 810-984-5005
Practice Fax:

1720104680 — C&T ENTERPRISES, INC.
Practice Location Address:

3957 24TH AVE
FORT GRATIOT, MI
48059-4102

Practice Phone: 810-984-5005
Practice Fax:

1124294236 — ALCOTT BLUE WATER CHIROPRACTIC, INC.
Practice Location Address:

3941 24TH AVE
FORT GRATIOT, MI
48059-4102

Practice Phone: 810-985-6868
Practice Fax: 810-985-6991

1316558877 — YALE ORTHODONTICS PLLC
Practice Location Address:

3901 24TH AVE
FORT GRATIOT, MI
48059-4102

Practice Phone: 810-984-1586
Practice Fax:

Directions to “ THOMAS LEES OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.