Individual
DR. MARCUS WAYNE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3631 BIENVILLE BLVD, SUITE A, OCEAN SPRINGS, MS 39564-5702
(228) 818-9620
(228) 818-9750
Mailing address
3631 BIENVILLE BLVD, SUITE A, OCEAN SPRINGS, MS 39564-5702
(228) 818-9620
(228) 818-9750
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
20353
MS
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
20353
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01931896
—
MS
01
—
302I373520
MEDICARE PTAN
MS
Enumeration date
06/23/2007
Last updated
05/12/2016
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