Individual
DR. JONATHAN C LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7221 ENGLE RD STE 220, FORT WAYNE, IN 46804-2233
(260) 432-1568
(260) 432-4969
Mailing address
7221 ENGLE RD STE 220, FORT WAYNE, IN 46804-2233
(260) 432-1568
(260) 432-4969
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
5118-850
WI
2085R0202X
Diagnostic Radiology Physician
01073121A
IN
2085R0202X
Diagnostic Radiology Physician
62743
WI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01073121A
IN
2085R0204X
Vascular & Interventional Radiology Physician
62743
WI
Other
Enumeration date
06/26/2012
Last updated
01/22/2026
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