Lee, Phyllis

Lee, Phyllis is an individual health care provider with primary practice located at 855 N Westhaven Dr , Oshkosh WI 54904-7668. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Lee, Phyllis can be contacted via phone (920) 303-8700.

Contact Information

Primary practice address
855 N Westhaven Dr Oshkosh WI 54904-7668
Fax: (920) 456-5901
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 40466-020 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 40466-020 Wisconsin

Profile Details

NPI number 1124010749
LBN Legal business name Lee, Phyllis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Nov 19th, 2021 - about 3 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 1124010749 NPPES
Wisconsin MEDICAID 32476700

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