Individual
LEE THEODORE BOTTEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4700 W URBANA ST, BROKEN ARROW, OK 74012-5997
(918) 290-2300
(918) 290-2310
Mailing address
4700 W URBANA ST, BROKEN ARROW, OK 74012-5997
(918) 290-2300
(918) 290-2310
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4175
OK
Other
Enumeration date
04/01/2008
Last updated
09/06/2019
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