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NPI Code Detail

MEDICARE: MR. MICHAEL EUGENE LEE D.PH.

MEDICARE:  MR. MICHAEL EUGENE LEE  D.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist9377OK

General Provider Information

NPI Number : 1851433734
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL EUGENE LEE D.PH.
Provider Business Mailing Address
First Line : 705 E MAIN ST
Second Line :
City : DAVIS
State : OK
Zip : 73030-1913
Country : US
Telephone Number : 580-369-3776
Fax Number : 580-369-2115
Provider Business Practice Location Address
First Line : 705 E MAIN ST
Second Line :
City : DAVIS
State : OK
Zip : 73030-1913
Country : US
Telephone Number : 580-369-3776
Fax Number : 580-369-2115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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Directions to “ MR. MICHAEL EUGENE LEE D.PH.” Practice Location

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