MEDICARE: DR. CHELSEA RAY LEE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	0549397	KS

General Provider Information

NPI Number	:	1104122266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHELSEA RAY LEE DO

Provider Business Mailing Address
First Line	:	9300 E 29TH ST N STE 310
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-2160
Country	:	US
Telephone Number	:	316-612-1833
Fax Number	:	316-612-2420

Provider Business Practice Location Address
First Line	:	13213 W 21ST CT N
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67235-9625
Country	:	US
Telephone Number	:	316-612-1833
Fax Number	:	316-612-2420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	09/15/2025

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