MEDICARE: DR. DAVID Q LE DPM

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	POD233	OK
2	213E00000X	Podiatrist	233	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962566307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID Q LE DPM

Provider Business Mailing Address
First Line	:	9315 S. PENNSYLVANIA AVE
Second Line	:	SUITE A
City	:	OKC
State	:	OK
Zip	:	73159-6913
Country	:	US
Telephone Number	:	405-691-9004
Fax Number	:	405-691-9003

Provider Business Practice Location Address
First Line	:	9315 S PENNSYLVANIA AVE STE A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-6913
Country	:	US
Telephone Number	:	405-691-9004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	03/11/2011

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Directions to “ DR. DAVID Q LE DPM” Practice Location

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