Healthcare Provider Details

I. General information

NPI: 1376500215
Provider Name (Legal Business Name): KHOA LE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N KENTUCKY AVE
WEST PLAINS MO
65775-2029
US

IV. Provider business mailing address

360 LINDEN OAKS STE 300
ROCHESTER NY
14625-2814
US

V. Phone/Fax

Practice location:
  • Phone: 417-256-1774
  • Fax: 417-256-1794
Mailing address:
  • Phone: 585-383-8830
  • Fax: 585-383-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number300900
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number61665991
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: