Provider Demographics
NPI:1316965684
Name:LEE, JOU R (MD)
Entity type:Individual
Prefix:DR
First Name:JOU
Middle Name:R
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 1:945 N GEM ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2127
Mailing Address - Country:US
Mailing Address - Phone:559-686-4199
Mailing Address - Fax:559-686-6685
Practice Address - Street 1:945 N GEM ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2127
Practice Address - Country:US
Practice Address - Phone:559-686-4199
Practice Address - Fax:559-686-6685
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41102207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD09801Medicare ID - Type Unspecified