Individual
RICHARD LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-2539
(706) 721-8623
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2000148981
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
81540
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
177919
BLUE CROSS BLUE SHIELD
—
05
—
208836809
—
MO
01
—
42733
HEALTHCARE USA
—
01
—
551829
HEALTHLINK
—
01
—
7395391
AETNA
—
01
—
84115
HEALTH ALLIANCE
—
01
—
O00078116
MEDICARE RAILROAD
MO
Enumeration date
08/29/2006
Last updated
04/11/2019
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