MEDICARE: LAUREL MADISON LEE PA-C

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	363A00000X	Physician Assistant	6564	TN

General Provider Information

NPI Number	:	1477442317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREL MADISON LEE PA-C

Provider Business Mailing Address
First Line	:	843 ROGERS RD
Second Line	:
City	:	GALLATIN
State	:	TN
Zip	:	37066-3023
Country	:	US
Telephone Number	:	423-432-1189
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 ASPEN GROVE DR STE 100
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-4875
Country	:	US
Telephone Number	:	888-938-3838
Fax Number	:

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

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/08/2025

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