Individual
IRVIN A. LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5150
Mailing address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5150
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
9003
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002102796
—
NV
01
—
480026055
RR GROUP #
NV
Enumeration date
07/27/2006
Last updated
12/07/2010
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