Provider Demographics
NPI:1821012253
Name:LEE, GRAHAM K (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:K
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4801 W 110TH ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1347
Mailing Address - Country:US
Mailing Address - Phone:816-276-3493
Mailing Address - Fax:913-491-0411
Practice Address - Street 1:4801 W 110TH ST
Practice Address - Street 2:STE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1347
Practice Address - Country:US
Practice Address - Phone:816-276-3493
Practice Address - Fax:913-491-0411
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO1005362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203728126Medicaid
MO300091992OtherRAILROAD MEDICARE
KS100154500CMedicaid
MO300095390OtherRAILROAD MEDICARE
MO30095390OtherRAILROAD MEDICARE
MO1528169752OtherSECOND NPI NUMBER FOR MEDICARE GROUP # I23000A
18395094OtherBCBS KANSAS CITY
MO1528169752OtherSECOND NPI NUMBER FOR MEDICARE GROUP # I23000A
MO30095390OtherRAILROAD MEDICARE
MOI233185Medicare PIN
MOI233185AMedicare PIN