Provider Demographics
NPI:1306916812
Name:DOREY, LEE R (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:R
Last Name:DOREY
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 1:2100 N WALDRON
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502
Mailing Address - Country:US
Mailing Address - Phone:620-664-6774
Mailing Address - Fax:620-664-5227
Practice Address - Street 1:2100 N WALDRON
Practice Address - Street 2:SUITE 5
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502
Practice Address - Country:US
Practice Address - Phone:620-664-6774
Practice Address - Fax:620-664-5227
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427315207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS053304OtherBCBS
KS2086211301Medicaid
KS053304OtherBCBS
KS053304Medicare ID - Type Unspecified