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Individual

DR. PATRICIA LEE JUNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1317 S MAIN ST, MOULTRIE, GA 31768-5809
(229) 985-7177
(229) 890-5373
Mailing address
1317 S MAIN ST, MOULTRIE, GA 31768-5809
(229) 985-7177
(229) 890-5373

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17838
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000292025A
GA
01
117463
PSHP
GA
01
1730268459
BLUE CROSS BLUE SHIELD
GA
01
N355136
WELLCARE
GA
Enumeration date
11/03/2006
Last updated
05/16/2008
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