Provider Demographics
NPI:1417920257
Name:LEE D. HIEB, M.D., P.C.
Entity Type:Organization
Organization Name:LEE D. HIEB, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HIEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-344-8220
Mailing Address - Street 1:PO BOX 27340
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85061-7340
Mailing Address - Country:US
Mailing Address - Phone:602-943-9200
Mailing Address - Fax:630-221-6300
Practice Address - Street 1:2051 W 25TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6911
Practice Address - Country:US
Practice Address - Phone:928-344-8220
Practice Address - Fax:928-726-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCI6281Medicare PIN
AZ1064210001Medicare NSC
AZZ23059Medicare PIN