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NPI Code Detail

MEDICARE: PHILIP S. LEE MD

MEDICARE: PHILIP S. 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
1207R00000XInternal Medicine PhysicianMS21787MS

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 : 1770594368
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP S. LEE MD
Provider Business Mailing Address
First Line : PO BOX 480
Second Line :
City : MACON
State : MS
Zip : 39341-0480
Country : US
Telephone Number : 662-726-4264
Fax Number :
Provider Business Practice Location Address
First Line : 78 HOSPITAL RD
Second Line :
City : MACON
State : MS
Zip : 39341-2490
Country : US
Telephone Number : 662-726-4264
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 02/24/2015

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