Organization
PSYCHIATRY LEE AND ASSOCIATES PC
Active
Other names
Lee & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANG OUG LEE MD (OWNER MEDICAL DIRECTOR)
(515) 574-6120
Entity
Organization
Contact information
Practice address
804 KENYON ROAD, SUITE A, FORT DODGE, IA 50501-5742
(515) 574-6120
(515) 574-6125
Mailing address
804 KENYON ROAD, SUITE A, FORT DODGE, IA 50501-5742
(515) 574-6120
(515) 574-6125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
00596
IA
2084P0800X
Psychiatry Physician
Primary
21456
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
I059525
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091223
—
IA
01
—
10195
BLUE CROSS BLUE SHIELD
IA
Enumeration date
03/29/2006
Last updated
02/17/2012
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