Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35-06-4792 | OH |
NPI | 1063405868 |
---|---|
Provider Name | Dr. Thomas H. Lee |
First Address | Pickerington, OH 43147-8235 |
Second Address | Pickerington, OH 43147-8235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0929035 | (05) | OH |
F59757 | (02) | OH |