Organization
ROBERT J. LEE, M.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT JENSEN LEE M.D. (OWNER)
(208) 522-4409
Entity
Organization
Contact information
Practice address
3446 S 15TH E, IDAHO FALLS, ID 83404-8262
(208) 522-4409
(208) 522-4497
Mailing address
PO BOX 1583, IDAHO FALLS, ID 83403-1583
(208) 522-4409
(208) 522-4497
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M7277
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356500086
GROUP NPI
ID
05
—
135650086001
—
ID
05
—
135650086002
—
ID
01
—
1710985551
INDIVIDUAL NPI
ID
05
—
1710985551001
—
ID
Enumeration date
06/06/2008
Last updated
09/11/2010
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