Provider Demographics
NPI:1225469497
Name:YUNG GIL LEE MD PC
Entity Type:Organization
Organization Name:YUNG GIL LEE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUNG
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:423-263-5400
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37331-0775
Mailing Address - Country:US
Mailing Address - Phone:423-263-5400
Mailing Address - Fax:423-263-0674
Practice Address - Street 1:315 GRADY RD
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-1903
Practice Address - Country:US
Practice Address - Phone:423-263-5400
Practice Address - Fax:423-263-0674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty