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NPI Code Detail

MEDICARE: TONY W LEE DO

MEDICARE: TONY W 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
1207R00000XInternal Medicine Physician008943AZ

General Provider Information

NPI Number : 1497753123
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONY W LEE DO
Provider Business Mailing Address
First Line : 10086 W EL CORTEZ PL
Second Line :
City : PEORIA
State : AZ
Zip : 85383-1458
Country : US
Telephone Number : 480-673-9931
Fax Number :
Provider Business Practice Location Address
First Line : 5555 W THUNDERBIRD RD
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-4622
Country : US
Telephone Number : 602-865-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 08/05/2021

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