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NPI Code Detail

MEDICARE: JOHN J LEE D.O.

MEDICARE: JOHN J LEE D.O.
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
12084P0800XPsychiatry Physician4150AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568534741
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN J LEE D.O.
Provider Business Mailing Address
First Line : 3101 N CENTRAL AVE STE 550
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2635
Country : US
Telephone Number : 602-230-7373
Fax Number :
Provider Business Practice Location Address
First Line : 3033 N CENTRAL AVE STE 700
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2806
Country : US
Telephone Number : 602-230-7373
Fax Number : 602-257-8029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 03/09/2026

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