1285629733 NPI number — DR. LEE WILLIAM JANSON PHD, MD

Table of content: DR. LEE WILLIAM JANSON PHD, MD (NPI 1285629733)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285629733 NPI number — DR. LEE WILLIAM JANSON PHD, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JANSON
Provider First Name:
LEE
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285629733
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4/9 ADVOCATES CLOSE
Provider Second Line Business Mailing Address:
357 HIGH STREET
Provider Business Mailing Address City Name:
EDINBURGH
Provider Business Mailing Address State Name:
SCOTLAND
Provider Business Mailing Address Postal Code:
EH1 1PS
Provider Business Mailing Address Country Code:
GB
Provider Business Mailing Address Telephone Number:
441312252117
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4/9 ADVOCATES CLOSE
Provider Second Line Business Practice Location Address:
357 HIGH STREET
Provider Business Practice Location Address City Name:
EDINBURGH
Provider Business Practice Location Address State Name:
SCOTLAND
Provider Business Practice Location Address Postal Code:
EH1 1PS
Provider Business Practice Location Address Country Code:
GB
Provider Business Practice Location Address Telephone Number:
441312252117
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  L4006 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: L4006 . This is a "TEXAS STATEBOARD OF MEDICAL EXAMINERS (TEXAS MEDICAL LICENSE)" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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