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NPI Code Detail

MEDICARE: JESSICA DAWN LEE PA

MEDICARE:   JESSICA DAWN LEE  PA
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
1363A00000XPhysician AssistantMA064208PA
2363A00000XPhysician Assistant005749GA

General Provider Information

NPI Number : 1447321518
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA DAWN LEE PA
Provider Business Mailing Address
First Line : 2727 PACES FERRY RD SE STE 1-1100
Second Line :
City : ATLANTA
State : GA
Zip : 30339-6151
Country : US
Telephone Number : 404-605-5699
Fax Number : 404-609-7514
Provider Business Practice Location Address
First Line : 95 COLLIER RD NW STE 5015
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1721
Country : US
Telephone Number : 404-605-5699
Fax Number : 404-609-7514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2006
Last Update Date : 05/08/2023

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Directions to “ JESSICA DAWN LEE PA” Practice Location

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