Provider Demographics
NPI:1407896087
Name:GARRETT, LEE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:S
Last Name:GARRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 HWY 70 WEST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28577
Mailing Address - Country:US
Mailing Address - Phone:603-437-8467
Mailing Address - Fax:252-240-1840
Practice Address - Street 1:59 SHEFFIELD RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2314
Practice Address - Country:US
Practice Address - Phone:603-606-7020
Practice Address - Fax:603-622-4102
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3644754OtherAETNA PROVIDER ID
NHAA21573OtherHARVARD HEALTHCARE
NH406304OtherTUFTS
NH0106889YPNH03OtherANTHEM
NH2913893OtherCIGNA
NH30001537Medicaid
NH3644754OtherAETNA PROVIDER ID
NH406304OtherTUFTS