MEDICARE: DR. AMY LYNN LEE MD

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	207R00000X	Internal Medicine Physician	23884	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1699760751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY LYNN LEE MD

Provider Business Mailing Address
First Line	:	9225 N 3RD ST STE 300
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2466
Country	:	US
Telephone Number	:	602-445-0751
Fax Number	:	602-424-8128

Provider Business Practice Location Address
First Line	:	9225 N 3RD ST STE 300
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2466
Country	:	US
Telephone Number	:	602-445-0751
Fax Number	:	602-424-8128

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	03/08/2016

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