Provider Demographics
NPI:1477592467
Name:LEE, KAREN E (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
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 1:63701 E SADDLEBROOKE BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-1273
Mailing Address - Country:US
Mailing Address - Phone:520-818-0300
Mailing Address - Fax:
Practice Address - Street 1:63701 E SADDLEBROOKE BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-1273
Practice Address - Country:US
Practice Address - Phone:520-818-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216493207Q00000X
MN43414207Q00000X
AZ51203207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN564133100Medicaid
AZZ183062Medicare PIN
MN564133100Medicaid
080010543Medicare PIN