Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 01078675A | IN |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 52780 | TN |
NPI | 1134207095 |
---|---|
Provider Name | Lawrence S Lee |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-1228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 01/12/2020 |