Provider Demographics
NPI:1164592077
Name:LEE LOY, LAMBERT K (MD)
Entity Type:Individual
Prefix:DR
First Name:LAMBERT
Middle Name:K
Last Name:LEE LOY
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 390932
Mailing Address - Street 2:
Mailing Address - City:KEAUHOU
Mailing Address - State:HI
Mailing Address - Zip Code:96739-0932
Mailing Address - Country:US
Mailing Address - Phone:808-322-2750
Mailing Address - Fax:808-322-2995
Practice Address - Street 1:78-6831 ALII DR STE 116
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2440
Practice Address - Country:US
Practice Address - Phone:808-322-2750
Practice Address - Fax:808-322-2995
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0 021465-0OtherHMSA PROVIDER NUMBER
HI013254 01Medicaid
HI013254 01Medicaid
HIC97475Medicare UPIN