Organization Name: | YUNG GIL LEE MD PC |
NPI Number: | 1225469497 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | YUNG G LEE (PRESIDENT) |
Mailing Address: | 315 Grady Rd Etowah |
State: | TN US |
Postal Code: | 373311903 |
Phone Number: | 4232635400 |
Fax Number: | 4232630674 |
NPI Enumeration Date: | 12/12/2013 |
NPI Last Update Date: | 12/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |