Provider Demographics
NPI:1245272210
Name:LEE, TIFFANY (MD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
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 1:4150 SNAPFINGER WOODS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3417
Mailing Address - Country:US
Mailing Address - Phone:404-286-7857
Mailing Address - Fax:404-286-7858
Practice Address - Street 1:4150 SNAPFINGER WOODS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3417
Practice Address - Country:US
Practice Address - Phone:404-286-7857
Practice Address - Fax:404-286-7858
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine