Mary a Lee MD Inc

Key facts

NPI

1043373517

Entity type

Organization (NPI type 2)

Primary specialty

Internal Medicine Physician 207R00000X

License

35041350 (OH)

Legal business name

MARY A LEE MD INC

Practice address

6746 Dick Flynn Blvd
Goshen, OH 45122-8609

Phone

(513) 722-2603

Fax

(513) 722-3423

NPI assigned

Dec 18, 2006

Organization subpart

No

Authorized official

Name

Dr. Mary A Lee, MD

Title

President

Phone

(513) 722-2603

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 29, 2011.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1043373517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6746 DICK FLYNN BLVD",
            "city": "GOSHEN",
            "state": "OH",
            "postal_code": "451228609",
            "telephone_number": "513-722-2603",
            "fax_number": "513-722-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6746 DICK FLYNN BLVD",
            "city": "GOSHEN",
            "state": "OH",
            "postal_code": "451228609",
            "telephone_number": "513-722-2603",
            "fax_number": "513-722-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY A LEE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-722-2603",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35041350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0344041",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00608181",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, OH

• Liz Loving Hands Home Care
• Regina M Lovette
• Hailey Lovins
• Miranda Danielle Lovins
• Kimberly J Maki, DO
• Joseph F McAuliffe
• Flora. McKeehan
• Emily Lynne Mecimore, RN
• Angela Meece, LPN
• Mellon Ridge, Inc.

All providers in Goshen, OH · Internal Medicine Physician in Ohio