Provider Demographics
NPI:1740289891
Name:LEE, SHAWNAREE L (DO)
Entity type:Individual
Prefix:
First Name:SHAWNAREE
Middle Name:L
Last Name:LEE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:SHAWNAREE
Other - Middle Name:L
Other - Last Name:HAMLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4651 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-1440
Mailing Address - Country:US
Mailing Address - Phone:405-395-5655
Mailing Address - Fax:405-395-5654
Practice Address - Street 1:4651 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-1440
Practice Address - Country:US
Practice Address - Phone:405-395-5655
Practice Address - Fax:405-395-5654
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3760207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ181832Medicaid
OK200032960AMedicaid
I14411Medicare UPIN
OK243425101Medicare PIN