Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 00000656 | CO |
NPI | 1124060488 |
---|---|
Provider Name | Lee T Fleming |
First Address | Colorado Springs, CO 80924-2025 |
Second Address | Colorado Springs, CO 80920-3959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V10850 | (02) | CO |