Individual
DR. KEVIN HARRY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
574 ALLISON ST, ASHLAND, OR 97520-2910
(989) 600-0785
(541) 789-6461
Mailing address
574 ALLISON ST, ASHLAND, OR 97520-2910
(989) 600-0785
(541) 789-6461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101008929
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P43930
MEDICARE GROUP
MI
05
—
114982630
—
MI
05
—
3512728
—
MI
01
—
KL008929
BCBS
MI
Enumeration date
07/14/2006
Last updated
12/11/2014
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