Lee Bottem DO PLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4175 Issued in OK

Legal business name

LEE BOTTEM DO PLC

Practice address

3131 Military Blvd
Muskogee, OK 74401-2290

Phone

(918) 994-4104

Fax

(918) 994-4106

NPI assigned

Sep 9, 2015

Organization subpart

No

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

Authorized official

Name

Aisha D Hair, MBA, OMT

Title

Practice Manager

Phone

(918) 994-4104

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lee Theodore Bottem, D.O.

  • Ophthalmology Physician
  • Broken Arrow, OK
  • NPI 1679745418
  NPD (past)

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1700254661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 E 91ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741373602",
            "telephone_number": "918-994-4104",
            "fax_number": "918-994-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 MILITARY BLVD",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012290",
            "telephone_number": "918-994-4104",
            "fax_number": "918-994-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE BOTTEM DO PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "HAIR",
        "authorized_official_first_name": "AISHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "918-994-4104",
        "authorized_official_credential": "MBA, OMT"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "4175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heaven Lax
• Nguyen Thao Thi Le, PHARMD
• Alisha Lea
• Arika Leach, COTA
• Leigh Ellen Leatherman
• Autumn Nicole Lee
• Geraldine Lee
• Jaclyn L Lee, MSW
• James Marvin Lee, PH.D.
• Patsy Denice Lee

• Ophthalmology Physician in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Ophthalmology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.