Provider Demographics
NPI:1134135015
Name:LEE, WOOK H (MD)
Entity Type:Individual
Prefix:DR
First Name:WOOK
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-0145
Mailing Address - Country:US
Mailing Address - Phone:319-826-3763
Mailing Address - Fax:319-826-3766
Practice Address - Street 1:701 10TH SEST
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-1251
Practice Address - Country:US
Practice Address - Phone:319-398-6180
Practice Address - Fax:319-398-6708
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA366022085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0764472Medicaid
IA0764472Medicaid