Church, Lee Thomas

Church, Lee Thomas is an sole proprietor health care provider with primary practice located at 60Mdg/Sgof 101 Bodin Cir, Travis Afb CA 94535-1800. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Church, Lee Thomas can be contacted via phone (218) 259-8740.

Contact Information

Primary practice address
60Mdg/Sgof 101 Bodin Cir Travis Afb CA 94535-1800
Phone: (218) 259-8740
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 27080 Nebraska
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 16373 Nevada
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 16373 Nevada

Profile Details

NPI number 1235428889
LBN Legal business name Church, Lee Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 5th, 2011
Last updated Mar 10th, 2020 - 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 1235428889 NPPES
Nevada MEDICAID 1235428889

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