Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 0437749 | KS |
NPI | 1023083466 |
---|---|
Provider Name | Dr. Ryan S Lee |
First Address | Phillipsburg, KS 67661-0547 |
Second Address | Phillipsburg, KS 67661-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 04/03/2015 |