Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 04-36419 | KS |
N | 208800000X | Urologist | 2013015498 | MO |
NPI | 1033230933 |
---|---|
Provider Name | Dr. Eugene Kang Lee |
First Address | Kansas City, KS 66160-8500 |
Second Address | Kansas City, KS 66160-8500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 16/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
297895901 | (05) | TX |