Provider Demographics
NPI:1114941820
Name:LEE, ROBERT HAYES (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HAYES
Last Name:LEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 E 47TH PL
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2914
Mailing Address - Country:US
Mailing Address - Phone:918-749-4484
Mailing Address - Fax:918-749-2350
Practice Address - Street 1:3315 E 47TH PL
Practice Address - Street 2:SUITE 102
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2914
Practice Address - Country:US
Practice Address - Phone:918-749-4484
Practice Address - Fax:918-749-2350
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK188213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist