Dr Constance W Lee, MD | |
1 Childrens Pl Ste A, Ste A, Saint Louis, MO 63110-1002 | |
(314) 454-6070 | |
(314) 454-2442 |
Full Name | Dr Constance W Lee |
---|---|
Gender | Female |
Speciality | Surgery - Pediatric Surgery |
Location | 1 Childrens Pl Ste A, Saint Louis, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619036993 | NPI | - | NPPES |
161903699 | Medicaid | MO | |
ENROLLED | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 2016013269 (Missouri) | Secondary |
2086S0120X | Surgery - Pediatric Surgery | MD215943 (Oregon) | Primary |
Entity Name | Southern California Permanente Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
Mailing Address | Practice Location Address |
---|---|
Dr Constance W Lee, MD 660 S Euclid Ave, C B 8235, Saint Louis, MO 63110-1010 Ph: (314) 454-6070 | Dr Constance W Lee, MD 1 Childrens Pl Ste A, Ste A, Saint Louis, MO 63110-1002 Ph: (314) 454-6070 |
Dr. Matthew Russell Smeds, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1225 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-977-4730 Fax: 314-977-1642 | |
Dr. William C Chapman Jr., MD Surgery Medicare: Medicare Enrolled Practice Location: 1044 N Mason Rd, Div Surg Colon/rectal, Ste 310, Saint Louis, MO 63141 Phone: 314-454-7177 Fax: 888-425-7946 | |
Dr. Bradley Seth Kushner, MD Surgery Medicare: Medicare Enrolled Practice Location: 1 Barnes Jewish Hospital Plz, Div Surg Vascular, Saint Louis, MO 63110 Phone: 314-273-7373 Fax: 888-840-6225 | |
Leonardo J Diaz Gandica, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 510 S Kingshighway Blvd, Saint Louis, MO 63110 Phone: 314-286-2000 | |
Eddy C Hsueh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3655 Vista Ave, Saint Louis, MO 63110 Phone: 314-977-4440 Fax: 314-977-1630 | |
Dr. Lj Punch, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 5501 Delmar Blvd Ste A430, Saint Louis, MO 63112 Phone: 314-624-0398 | |
Dr. David Caplin, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 845 N New Ballas Ct, Suite 300, Saint Louis, MO 63141 Phone: 314-569-0130 Fax: 314-569-3674 |