Lee, Matthew R

Lee, Matthew R is an individual health care provider with primary practice located at 1900 West Fourth Street Suite 4, Mount Vernon IN 47620. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lee, Matthew R can be contacted via phone (812) 838-4891.

Contact Information

Primary practice address
1900 West Fourth Street Suite 4 Mount Vernon IN 47620
Fax: (812) 838-6595
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01032902 Indiana

Profile Details

NPI number 1902842941
LBN Legal business name Lee, Matthew R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Feb 25th, 2010 - about 15 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 1902842941 NPPES
Indiana Other 000000043063 BCBS
Indiana MEDICAID 100210240A BCBS

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