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Individual

MARK J LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
910 WALLACE AVE, LEITCHFIELD, KY 42754-2414
(270) 259-2700
(270) 259-2717
Mailing address
908 WALLACE AVE, LEITCHFIELD, KY 42754-1479
(270) 259-2700
(270) 259-2717

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02935
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64124720
KY
Enumeration date
05/31/2006
Last updated
07/24/2019
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