Provider Demographics
NPI:1225474588
Name:LEE, JAY SOONG-JIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:SOONG-JIN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 DUKE MEDICINE CIR
Mailing Address - Street 2:DUMC 3966
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:919-684-6858
Mailing Address - Fax:919-684-6044
Practice Address - Street 1:20 DUKE MEDICINE CIR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-6007
Practice Address - Country:US
Practice Address - Phone:734-260-6914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-018892086X0206X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty