Active NPI
Sang Gang Lee, MD
- Pulmonary Disease Physician
- Muskogee, OK
National Provider Identifier
1023059029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 16383
- Practice address
- 615 S 32ND St
Muskogee, OK 74401 - Phone
- (918) 687-3994
- Fax
- (918) 687-1809
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16383 | OK | |
| Pulmonary Disease Physician | 207RP1001X | 16383 | OK | Primary |
Addresses
Primary practice location
615 S 32ND St
Muskogee, OK 74401
Mailing address
615 S 32ND St
Muskogee, OK 74401
Phone (918) 687-3994
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100210940A | Medicaid | OK | |
| 110113959 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398211200000",
"number": "1023059029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S 32ND ST",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "74401",
"telephone_number": "918-687-3994",
"fax_number": "918-687-1809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S 32ND ST",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "74401",
"telephone_number": "918-687-3994",
"fax_number": "918-687-1809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SANG",
"middle_name": "GANG",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2014-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "16383",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "OK",
"license": "16383",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100210940A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110113959",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.