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General NPI Number Information
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NPI Number | 1952388548
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Entity Type | Individual
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Provider Name | LEE COREY HAIKAL MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 10/18/2020
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Provider Practice Location Address
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Address Line | 5221 US ROUTE 60 E RADIOLOGY INC
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City | HUNTINGTON
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State | WV
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Zip | 25705-2022
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Country | US
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Telephone | 304-522-1550
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Fax | 304-522-0704
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Provider Business Mailing Address
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Address Line | PO BOX 910 RADIOLOGY INC
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City | HUNTINGTON
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State | WV
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Zip | 25712-0910
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Country | US
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Telephone | 304-522-1550
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Fax | 304-522-1073
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 31922
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35-078227-H
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 19783
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 31922
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License Number State | KY
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