Provider Demographics
NPI:1770845893
Name:LEE, ELIZABETH SOON (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SOON
Last Name:LEE
Suffix:
Gender:F
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:PO BOX 13627
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85732-3627
Mailing Address - Country:US
Mailing Address - Phone:520-750-7255
Mailing Address - Fax:520-545-7261
Practice Address - Street 1:7436 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2306
Practice Address - Country:US
Practice Address - Phone:520-297-3300
Practice Address - Fax:520-888-2698
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ60718208200000X
TN557552086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery