Dittrich, Lee B

Dittrich, Lee B is an individual health care provider with primary practice located at 123 Fox Rd , Knoxville TN 37922-3369. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Dittrich, Lee B can be contacted via phone (865) 690-9467.

Contact Information

Primary practice address
123 Fox Rd Knoxville TN 37922-3369
Phone: (865) 690-9467
Fax: (865) 637-5057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 36383 Tennessee

Profile Details

NPI number 1316905862
LBN Legal business name Dittrich, Lee B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Aug 7th, 2020 - about 4 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 1316905862 NPPES
Tennessee Other 7120405 AETNA
Tennessee Other 3874778 AETNA
Tennessee MEDICAID Q007919 AETNA

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