Basic Information
| Provider Information | |||||||||
| NPI: | 1952486292 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DANIEL LEE MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 MOCKINGBIRD LN | ||||||||
| Address2: | |||||||||
| City: | CHICKASHA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730185113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056472176 | ||||||||
| FaxNumber: | 4058793382 | ||||||||
| Practice Location | |||||||||
| Address1: | 8100 S WALKER AVE | ||||||||
| Address2: | BLDG C | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731399402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056026500 | ||||||||
| FaxNumber: | 4056026589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LEE | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | W. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4056472176 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.