| Doctor Name: | MR. LEE EDWARD ACKLEY |
| NPI Number: | 1417933813 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C, MPAS, RT(R) |
| License Number: | PA02732 |
| Business Practice Address: | 149 Hart St 82 Medical Group Credentials Sheppard Afb, TX - 763113482 |
| Business Phone Number: | 9406761667 |
| Business Fax Number: | 9406761693 |
| Mailing Address: | 383 Trs Xuff, 939 Missile Road SHEPPARD AFB |
| State: | TX |
| Postal Code: | 763112245 |
| Phone Number: | 9406761667 |
| Fax Number: | 9406761693 |
| NPI Enumeration Date: | 12/16/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA02732 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |