Provider Demographics
NPI:1043306400
Name:LEE A. ISON, MD, INC.
Entity Type:Organization
Organization Name:LEE A. ISON, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-737-6606
Mailing Address - Street 1:2817 PARKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4218
Mailing Address - Country:US
Mailing Address - Phone:405-737-6606
Mailing Address - Fax:405-737-2869
Practice Address - Street 1:2817 PARKLAWN DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4218
Practice Address - Country:US
Practice Address - Phone:405-737-6606
Practice Address - Fax:405-737-2869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty