Provider Demographics
NPI:1356334866
Name:LEE, CHRISTOPHER COLLINS (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:COLLINS
Last Name:LEE
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 1:13828 COURSEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817
Mailing Address - Country:US
Mailing Address - Phone:225-752-4530
Mailing Address - Fax:225-752-4652
Practice Address - Street 1:13828 COURSEY BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817
Practice Address - Country:US
Practice Address - Phone:225-752-4530
Practice Address - Fax:225-752-4652
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025495207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1578487Medicaid
H74438Medicare UPIN
LA4E673CK50Medicare ID - Type Unspecified
LA4E673C043Medicare ID - Type Unspecified