Individual
LEE PARKS THEAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 EOFF ST, WHEELING, WV 26003-3823
(304) 234-0123
Mailing address
2000 EOFF ST, WHEELING, WV 26003-3823
(304) 234-0123
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35067781T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020422
—
OH
Enumeration date
10/10/2006
Last updated
09/14/2012
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