Provider Demographics
NPI:1770677155
Name:LEE, JOSEPH C (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5356
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:PATHOLOGY ASSOCIATES
Practice Address - Street 2:1100 CENTRAL AVENUE SE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-841-1259
Practice Address - Fax:505-841-1373
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM82-76207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM28050Medicaid
NMNM301090Medicare PIN
NMNM301086Medicare PIN
NM28050Medicaid
F14782Medicare UPIN
NMNM301087Medicare PIN
NMNM301085Medicare PIN
341319903Medicare PIN
NMNM301091Medicare PIN
NMNM301088Medicare PIN