Active NPI
Matthew Ray Lee, PHARM.D.
- Pharmacist
- Tahlequah, OK
National Provider Identifier
1962588970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13829
- Practice address
- 2028 Mahaney Ave
Tahlequah, OK 74464-5783 - Phone
- (918) 431-0315
- Fax
- (918) 431-0316
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13829 | OK | Primary |
Addresses
Primary practice location
2028 Mahaney Ave
Tahlequah, OK 74464-5783
Mailing address
18043 W. 830 Rd.
Park Hill, OK 74451
Phone (918) 431-0315
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13829 | OK | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962588970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18043 W. 830 RD.",
"city": "PARK HILL",
"state": "OK",
"postal_code": "74451",
"telephone_number": "918-431-0315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2028 MAHANEY AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744645783",
"telephone_number": "918-431-0315",
"fax_number": "918-431-0316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MATTHEW",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "13829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.