Provider Demographics
NPI:1265471379
Name:LEE, JAMES K (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:K
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4802 NW 10TH ST
Mailing Address - Street 2:OCCUHEALTH ASSOCIATES
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-5816
Mailing Address - Country:US
Mailing Address - Phone:405-702-1667
Mailing Address - Fax:405-702-1613
Practice Address - Street 1:4802 NW 10TH ST
Practice Address - Street 2:OCCUHEALTH ASSOCIATES
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-5816
Practice Address - Country:US
Practice Address - Phone:405-702-1667
Practice Address - Fax:405-702-1613
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20919208100000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100107260BMedicaid
G33696Medicare UPIN