Individual
PAUL ANDREW LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2205 PAVILION DR, SUITE 201, KINGSPORT, TN 37660-4641
(423) 857-7650
(423) 857-7655
Mailing address
2205 PAVILION DR, SUITE 201, KINGSPORT, TN 37660-4641
(423) 857-7650
(423) 857-7655
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110840851
VA
363A00000X
Physician Assistant
Primary
424
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447279856
—
VA
05
—
1511020
—
TN
05
—
8923655
—
VA
01
—
P00698768
RAILROAD MEDICARE
TN
05
—
Q003286
—
TN
Enumeration date
07/18/2006
Last updated
02/15/2017
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