Lee, Ivy M

Lee, Ivy M is an individual health care provider with primary practice located at 514 W 2Nd St , Bloomington IN 47403-2316. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is her primary health care specialty. Lee, Ivy M can be contacted via phone (812) 353-3719.

Contact Information

Primary practice address
514 W 2Nd St Bloomington IN 47403-2316
Phone: (812) 353-3719
Fax: (812) 353-3713
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01049528 Indiana
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 01049528A Indiana

Profile Details

NPI number 1376573832
LBN Legal business name Lee, Ivy M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Dec 3rd, 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 1376573832 NPPES
Indiana MEDICAID 200203160

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