MEDICARE: CHRISTOPHER JASON 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	1090617

General Provider Information

NPI Number	:	1922338672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JASON LEE PA-C

Provider Business Mailing Address
First Line	:	5979 DESERT STORM AVE
Second Line	:	LAPOINTE HEALTH CLINIC
City	:	FORT CAMPBELL
State	:	KY
Zip	:	42223-5585
Country	:	US
Telephone Number	:	270-420-0091
Fax Number	:

Provider Business Practice Location Address
First Line	:	5979 DESERT STORM AVE
Second Line	:	LAPOINTE HEALTH CLINIC
City	:	FORT CAMPBELL
State	:	KY
Zip	:	42223-5585
Country	:	US
Telephone Number	:	270-420-0091
Fax Number	:

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

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	12/31/2009

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