Healthcare Provider Details

I. General information

NPI: 1902258841
Provider Name (Legal Business Name): YUANLI LEI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2016
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date: 09/09/2019
Reactivation Date: 09/17/2019

III. Provider practice location address

700 NE 13TH ST
OKLAHOMA CITY OK
73104-5004
US

IV. Provider business mailing address

800 STANTON L YOUNG BLVD # 6400
OKLAHOMA CITY OK
73104-5018
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4700
  • Fax:
Mailing address:
  • Phone: 405-271-5882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number43280
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number70101
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: