Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 16697 | AL |
NPI | 1225029259 |
---|---|
Provider Name | Dr. Harry A Lee |
First Address | Montgomery, AL 36111-2654 |
Second Address | Montgomery, AL 36111-2654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 28/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F72252 | (02) | AL |