Provider Demographics
NPI:1649280611
Name:THURBER, LEE T (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:T
Last Name:THURBER
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 1:1101 SOUTH 70TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510
Mailing Address - Country:US
Mailing Address - Phone:402-486-3132
Mailing Address - Fax:402-486-3187
Practice Address - Street 1:1101 SOUTH 70TH ST
Practice Address - Street 2:STE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-486-3132
Practice Address - Fax:402-486-3187
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22791207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I11353Medicare UPIN
099553Medicare PIN