Provider Demographics
NPI:1275606352
Name:DANIEL, LEE BUELL (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:BUELL
Last Name:DANIEL
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 1:244 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2200
Mailing Address - Country:US
Mailing Address - Phone:541-687-8900
Mailing Address - Fax:541-683-5389
Practice Address - Street 1:244 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2200
Practice Address - Country:US
Practice Address - Phone:541-687-8900
Practice Address - Fax:541-683-5389
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLL09000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORE84251Medicare UPIN