MEDICARE: JAMES K LEE M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	20919	OK
2	2083X0100X	Occupational Medicine Physician	20919	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265471379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES K LEE M.D.

Provider Business Mailing Address
First Line	:	4802 NW 10TH ST
Second Line	:	OCCUHEALTH ASSOCIATES
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-5816
Country	:	US
Telephone Number	:	405-702-1667
Fax Number	:	405-702-1613

Provider Business Practice Location Address
First Line	:	4802 NW 10TH ST
Second Line	:	OCCUHEALTH ASSOCIATES
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-5816
Country	:	US
Telephone Number	:	405-702-1667
Fax Number	:	405-702-1613

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	08/05/2008

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