Provider Demographics
NPI:1295831048
Name:BEN LEE MD LLC
Entity Type:Organization
Organization Name:BEN LEE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-783-9997
Mailing Address - Street 1:3701 S CLARKSON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3960
Mailing Address - Country:US
Mailing Address - Phone:303-783-9997
Mailing Address - Fax:303-761-8959
Practice Address - Street 1:3701 S CLARKSON ST STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3960
Practice Address - Country:US
Practice Address - Phone:303-783-9997
Practice Address - Fax:303-761-8959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36605208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLELE14843OtherANTHEM BCBS
CO10283242Medicaid
COG82788Medicare UPIN
COLELE14843OtherANTHEM BCBS