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Individual

DR. RICHARD LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1023 15TH AVE NW, ARDMORE, OK 73401-1810
(580) 223-7844
(580) 223-6285
Mailing address
1023 15TH AVE NW, ARDMORE, OK 73401-1810
(580) 223-7844
(580) 223-6285

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
201458
LA
2085R0202X
Diagnostic Radiology Physician
Primary
26215
OK
208D00000X
General Practice Physician
26215
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1014761
LA
05
200193740B
OK
01
26215
LICENSE
OK
Enumeration date
02/16/2006
Last updated
01/15/2016
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