Provider Demographics
NPI:1275238081
Name:LEE, AUSTIN JAMES (MD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JAMES
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 CHERRY ST
Mailing Address - Street 2:MOB2 SUITE M200
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608
Mailing Address - Country:US
Mailing Address - Phone:419-251-5819
Mailing Address - Fax:419-251-6859
Practice Address - Street 1:2222 CHERRY ST
Practice Address - Street 2:MOB2 SUITE M200
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608
Practice Address - Country:US
Practice Address - Phone:419-251-5819
Practice Address - Fax:419-251-6859
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program