Provider Demographics
NPI:1043483894
Name:OCCUHEALTH ASSOCIATES
Entity type:Organization
Organization Name:OCCUHEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE SHAREHOLDER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-600-6630
Mailing Address - Street 1:427 N MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-6509
Mailing Address - Country:US
Mailing Address - Phone:405-600-6630
Mailing Address - Fax:405-600-7112
Practice Address - Street 1:427 N MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-6509
Practice Address - Country:US
Practice Address - Phone:405-600-6630
Practice Address - Fax:405-600-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20919261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1265471379OtherINDIVIDUAL NPI, JAMES KEVIN LEE, M.D.