Provider Demographics
NPI:1295199289
Name:LEE, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
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 1:6020 WARDEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-6068
Mailing Address - Country:US
Mailing Address - Phone:501-552-6400
Mailing Address - Fax:501-552-6430
Practice Address - Street 1:6020 WARDEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-6068
Practice Address - Country:US
Practice Address - Phone:501-552-6400
Practice Address - Fax:501-552-6430
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-12777207T00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program