Katie Hyun Ju Lee, MD | |
1522 E A St, Casper, WY 82601-2217 | |
(307) 234-6161 | |
Not Available |
Full Name | Katie Hyun Ju Lee |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 1522 E A St, Casper, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528407186 | NPI | - | NPPES |
2074942 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 10232A (Wyoming) | Secondary |
207Q00000X | Family Medicine | 60672666 (Washington) | Primary |
Entity Name | Optum Care Washington Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831186766 PECOS PAC ID: 6406752153 Enrollment ID: O20031211000922 |
Mailing Address | Practice Location Address |
---|---|
Katie Hyun Ju Lee, MD 415 1st Ave N Unit 9486, Seattle, WA 98109-4591 Ph: (224) 572-1857 | Katie Hyun Ju Lee, MD 1522 E A St, Casper, WY 82601-2217 Ph: (307) 234-6161 |
Zachory Fred Deiss, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 | |
Philip Gard, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 | |
Dr. Johnny M Tooke, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2241 Farnum Ste 105, Casper, WY 82609 Phone: 307-266-1263 Fax: 307-265-0410 | |
Larissa Faith Gray, PA-C Family Medicine Medicare: Medicare Enrolled Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 | |
Adam Linck, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1020 S. Conwell Street, Casper, WY 82601 Phone: 307-265-8300 Fax: 307-233-8230 | |
Renae Marie Hepfner, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 | |
Sherrill A Fox, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6500 E 2nd St, Suite 200, Casper, WY 82609 Phone: 307-577-5100 Fax: 307-234-1201 |