Provider Demographics
NPI:1639171580
Name:LEE, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20375 W 151ST ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7218
Mailing Address - Country:US
Mailing Address - Phone:913-780-4000
Mailing Address - Fax:913-780-4038
Practice Address - Street 1:15123 S OMC PKWY
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7251
Practice Address - Country:US
Practice Address - Phone:913-780-4000
Practice Address - Fax:913-780-4038
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-20572207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100208120CMedicaid
KS13873018OtherBC/BS OF KC
KS13873018OtherBC/BS OF KC