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Individual

JAE SEUNG LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
350 W THOMAS RD, PHOENIX, AZ 85013
(602) 406-3874
(602) 406-2335
Mailing address
3030 N CENTRAL AVE STE 1001, PHOENIX, AZ 85012-2716
(602) 406-4786
(916) 636-4358

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
75669
TN
2085R0202X
Diagnostic Radiology Physician
Primary
55725
AZ
2085R0202X
Diagnostic Radiology Physician
S1636
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/23/2012
Last updated
10/21/2025
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