Provider Demographics
NPI:1013087451
Name:LEE, BENJAMIN R (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:R
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 245077
Mailing Address - Street 2:UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE, UROLOGY
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5077
Mailing Address - Country:US
Mailing Address - Phone:520-626-6895
Mailing Address - Fax:520-626-4933
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:DIVISION UROLOGY, BOX 245077
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5077
Practice Address - Country:US
Practice Address - Phone:520-626-6895
Practice Address - Fax:520-626-4933
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2016-07-23
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Provider Licenses
StateLicense IDTaxonomies
AZ51857208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H-12618Medicare UPIN