Basic Information
| Provider Information | |||||||||
| NPI: | 1821099979 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORSYTHE | ||||||||
| FirstName: | LEES | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4321 WASHINGTON ST | ||||||||
| Address2: | SUITE 6000 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641115961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167562255 | ||||||||
| FaxNumber: | 8169314080 | ||||||||
| Practice Location | |||||||||
| Address1: | 4321 WASHINGTON ST | ||||||||
| Address2: | SUITE 6000 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641115961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167562255 | ||||||||
| FaxNumber: | 8169314080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 02/24/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 29673 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 201107323 | 05 | MO | MEDICAID | 10001514100 | 01 | COMMUNITY HEALTH PLAN | OTHER | 100156330B | 05 | KS | MEDICAID | 04279040 | 01 | MO | BCBS KC | OTHER |