Provider Demographics
NPI:1306874144
Name:TEMPEL, LEE W (MD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:W
Last Name:TEMPEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11628 OLD BALLAS RD
Mailing Address - Street 2:STE 106
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7030
Mailing Address - Country:US
Mailing Address - Phone:314-593-2855
Mailing Address - Fax:636-487-0164
Practice Address - Street 1:11628 OLD BALLAS RD
Practice Address - Street 2:STE 106
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7030
Practice Address - Country:US
Practice Address - Phone:314-593-2855
Practice Address - Fax:636-487-0164
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2015-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO105681207R00000X
MOR1G892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202452330Medicaid
MO202452330Medicaid
000005119Medicare ID - Type Unspecified