Provider Demographics
NPI:1023083466
Name:LEE, RYAN S (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:S
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-0547
Mailing Address - Country:US
Mailing Address - Phone:785-543-5211
Mailing Address - Fax:785-543-5274
Practice Address - Street 1:1719 HIGHWAY 183
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-2549
Practice Address - Country:US
Practice Address - Phone:785-543-5211
Practice Address - Fax:785-543-5274
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0437749208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice