Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 01025655 | IN |
NPI | 1053310102 |
---|---|
Provider Name | Dr. Lorin Leslie Lee |
First Address | Indianapolis, IN 46227-7505 |
Second Address | Indianapolis, IN 46227-7505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 02/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100356430B | (05) | IN |
C24282 | (02) | IN |