Provider Demographics
NPI:1932357571
Name:LEE, RICKY WAI KEI (MD)
Entity Type:Individual
Prefix:
First Name:RICKY
Middle Name:WAI KEI
Last Name:LEE
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 1:848 N ST FRANCIS ST STE 3949
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3859
Mailing Address - Country:US
Mailing Address - Phone:316-268-8500
Mailing Address - Fax:316-291-7993
Practice Address - Street 1:848 N ST FRANCIS ST STE 3949
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3859
Practice Address - Country:US
Practice Address - Phone:316-268-8500
Practice Address - Fax:316-291-7993
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-377322084N0400X, 2084N0400X
ARE-83722084N0400X
MN544882084N0400X
CAA1053432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201112460AMedicaid
MNENROLLEDMedicaid