Lee, Brian J

Lee, Brian J is an individual health care provider with primary practice located at 7910 W Jefferson Blvd Ste 212 , Fort Wayne IN 46804-4159. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Lee, Brian J can be contacted via phone (260) 427-7473.

Contact Information

Primary practice address
7910 W Jefferson Blvd Ste 212 Fort Wayne IN 46804-4159
Phone: (260) 427-7473
Fax: (260) 432-3189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 01040298A Indiana

Profile Details

NPI number 1508867656
LBN Legal business name Lee, Brian J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Mar 6th, 2012 - about 12 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 1508867656 NPPES
Ohio MEDICAID 0984010
Ohio MEDICAID 100372020
Ohio Other 240007525
Ohio MEDICAID 104366796

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