Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 51857 | AZ |
NPI | 1013087451 |
---|---|
Provider Name | Dr. Benjamin R Lee |
First Address | Tucson, AZ 85724-5077 |
Second Address | Tucson, AZ 85724-5077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 23/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H-12618 | (02) |