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Individual

JOHN PAUL LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 MEDICAL LN, FOREST, MS 39074-4039
(601) 469-4861
(601) 469-1238
Mailing address
1 MEDICAL LN, PO BOX 600, FOREST, MS 39074-4039
(601) 469-4861
(601) 469-1238

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05638
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0116049
MS
Enumeration date
09/26/2006
Last updated
07/09/2007
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