Doctor Name: | KUO L LEE |
NPI Number: | 1659370682 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 014704 |
Business Practice Address: | 842 Professional Center Dr Eastman, GA - 310236734 |
Business Phone Number: | 4783744305 |
Business Fax Number: | 4783741366 |
Mailing Address: | 842 Professional Center Dr, EASTMAN |
State: | GA |
Postal Code: | 310236734 |
Phone Number: | 4783744305 |
Fax Number: | 4783741366 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 05/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/20/2006 |
NPI Reactivation Date: | 03/27/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 014704 |
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. |