Individual
DR. MARK THEODORE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1215 DUFF AVE, AMES, IA 50010-5469
(515) 239-4456
Mailing address
1215 DUFF AVE, AMES, IA 50010-5469
(515) 239-4400
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
DO-06912
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67264
MINNESOTA BOARD OF MEDICAL PRACTICE
MN
Enumeration date
03/30/2015
Last updated
06/30/2025
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