Provider Demographics
NPI:1295917839
Name:BURNETT, LEE A (DO)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:A
Last Name:BURNETT
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:
Mailing Address - City:TRIPLER ARMY MEDICAL CENTER
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-2459
Mailing Address - Fax:808-433-5460
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-2459
Practice Address - Fax:808-433-5460
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2024-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH02146Medicare UPIN