Healthcare Provider Details

I. General information

NPI: 1952486292
Provider Name (Legal Business Name): DANIEL LEE MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 S WALKER AVE BLDG C
OKLAHOMA CITY OK
73139-9402
US

IV. Provider business mailing address

105 MOCKINGBIRD LN
CHICKASHA OK
73018-5113
US

V. Phone/Fax

Practice location:
  • Phone: 405-602-6500
  • Fax: 405-602-6589
Mailing address:
  • Phone: 405-647-2176
  • Fax: 405-879-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL W. LEE
Title or Position: OWNER
Credential: MD
Phone: 405-647-2176