Provider Demographics
NPI:1144848177
Name:LEE, SAWYER
Entity type:Individual
Prefix:
First Name:SAWYER
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 S POST RD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-6610
Mailing Address - Country:US
Mailing Address - Phone:405-732-2244
Mailing Address - Fax:405-737-4776
Practice Address - Street 1:2008 S POST RD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6610
Practice Address - Country:US
Practice Address - Phone:405-732-2277
Practice Address - Fax:407-737-4776
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3083152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist