Antles, Lee A

Antles, Lee A is an individual health care provider with primary practice located at 9040 Jackson Avenue , Tacoma WA 98431-8151. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Antles, Lee A can be contacted via phone (253) 968-2462.

Contact Information

Primary practice address
9040 Jackson Avenue Tacoma WA 98431-8151
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00025946 Washington

Profile Details

NPI number 1811995525
LBN Legal business name Antles, Lee A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Mar 20th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811995525 NPPES
Other GAB34522 MEDICARE PTAN
Other 0168090 MEDICARE PTAN
Other 110245917 MEDICARE PTAN

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