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Individual

LEE COREY HAIKAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5221 US ROUTE 60 E, RADIOLOGY INC, HUNTINGTON, WV 25705-2022
(304) 522-1550
(304) 522-0704
Mailing address
PO BOX 910, RADIOLOGY INC, HUNTINGTON, WV 25712-0910
(304) 522-1550
(304) 522-1073

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
31922
KY
2085R0202X
Diagnostic Radiology Physician
35-078227-H
OH
2085R0204X
Vascular & Interventional Radiology Physician
19783
WV
2085R0204X
Vascular & Interventional Radiology Physician
Primary
31922
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000197340
UNISON
OH
01
001718783
MTN STATE BC BS
05
2215249
OH
01
300136878
RR MEDICARE (WV)
WV
01
50007287
PASSPORT
KY
01
5281384
AETNA
01
550493376 00
WORKMANS COMP
WV
05
6401188500
KY
05
7200721000
WV
Enumeration date
12/27/2005
Last updated
10/18/2020
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