Healthcare Provider Details

I. General information

NPI: 1205106077
Provider Name (Legal Business Name): SONG-PING LEE M.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 SW MULVANE ST STE 250
TOPEKA KS
66606-1685
US

IV. Provider business mailing address

823 SW MULVANE ST STE 250
TOPEKA KS
66606-1685
US

V. Phone/Fax

Practice location:
  • Phone: 785-233-6001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberKS0415590
License Number StateKS

VIII. Authorized Official

Name: DR. SONG-PING LEE
Title or Position: DOCTOR
Credential: M.D.
Phone: 785-233-6001