Individual
WANDA DETIEGE-LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 GILBREATH DR, ONEONTA FAMILY CLINIC, ONEONTA, AL 35121-2827
(205) 274-3353
(205) 274-3354
Mailing address
150 GILBREATH DR, ONEONTA FAMILY CLINIC, ONEONTA, AL 35121-2827
(205) 274-3353
(205) 274-3354
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
14415
AL
207P00000X
Emergency Medicine Physician
00014415
AL
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
14415
AL
207Q00000X
Family Medicine Physician
Primary
14415
AL
208D00000X
General Practice Physician
14415
AL
Other
Enumeration date
08/19/2006
Last updated
02/18/2011
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