Provider Demographics
NPI:1154420263
Name:BITTENBENDER, LEE R (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:R
Last Name:BITTENBENDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2200 SW 6TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1707
Mailing Address - Country:US
Mailing Address - Phone:785-354-8518
Mailing Address - Fax:785-354-1255
Practice Address - Street 1:3511 CLINTON PL STE C
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2213
Practice Address - Country:US
Practice Address - Phone:785-331-4488
Practice Address - Fax:785-331-4338
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS15200207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB91178Medicare UPIN
KS100093750AMedicaid
KS006529OtherBLUECROSS BLUESHIELD
KS006529Medicare ID - Type Unspecified