Sang O Lee, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

21456 Issued in IA

Practice address

804 Kenyon Road
Suite a
Fort Dodge, IA 50501-5742

Phone

(515) 574-6120

Fax

(515) 574-6135

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1396709457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 KENYON ROAD",
            "address_2": "SUITE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015742",
            "telephone_number": "515-574-6120",
            "fax_number": "515-574-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 KENYON ROAD",
            "address_2": "SUITE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015742",
            "telephone_number": "515-574-6120",
            "fax_number": "515-574-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANG",
        "middle_name": "O",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "21456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159806",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10198",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Lois Larson, ARNP
• Tonya B Larson, LISW
• Lori Lawman, CADC
• Amber Lawrence
• Michael W Lee, MD
• Xieng Khan Lee, D.D.S.
• Alexandria Leffler, LMHC
• Ronald Lemond
• Patrick A Lenane, O.D.
• Tyler Lennon, CADC, B.S.

• Psychiatry Physician in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.