Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | D3990 | TX |
N | 156FX1100X | Ophthalmic | 36344 | OK |
N | 156FX1800X | Optician | D3989 | TX |
Y | 175L00000X | Homeopath |
NPI | 1891987673 |
---|---|
Provider Name | Mr. Jeffery William Lee |
First Address | Ada, OK 74820-5805 |
Second Address | Ada, OK 74820-5805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 11/01/2008 |