Doctor Name: | LOUIS G LEE |
NPI Number: | 1053316521 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 021540 |
Business Practice Address: | 112 Mimosa Dr Thomasville, GA - 317926605 |
Business Phone Number: | 2292270045 |
Business Fax Number: | 2292279120 |
Mailing Address: | 7524 Summerhill Rd, BOSTON |
State: | GA |
Postal Code: | 316262754 |
Phone Number: | 2292270045 |
Fax Number: | 2292279120 |
NPI Enumeration Date: | 06/20/2005 |
NPI Last Update Date: | 03/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 021540 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |