DR. LEE LYLE WARDLAW MD NPI 1134200025

NPI Information

NPI: 1134200025
Provider Name: DR. LEE LYLE WARDLAW, MD
Classification: Internal Medicine - 207RG0100X
Entity Type: Individual

Specialization: Gastroenterology

Address:
1264 WESLEY DRIVE
#602
MEMPHIS, TN
ZIP 38116
Phone: (901) 396-0311
Get Directions

DR. Lee Lyle Wardlaw, MD is a gastroenterology internal medicine in Memphis, TN. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. DR. Lee Lyle Wardlaw, MD NPI is 1134200025. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1264 WESLEY DRIVE
#602
MEMPHIS, TN
ZIP 38116-459
Phone: (901) 396-0311
Fax: (901) 516-3869

The enumeration date for this NPI number is 10/18/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RG0100X	Internal Medicine	Gastroenterology	05332	MISSISSIPPI	No
2	207RG0100X	Internal Medicine	Gastroenterology	MD008559	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	B02611	MEDICARE UPIN
2	00014795	MEDICAID	MISSISSIPPI
3	1000000014	OTHER	MISSISSIPPI	MEDIARE
4	3700161	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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