Healthcare Provider Details

I. General information

NPI: 1235131483
Provider Name (Legal Business Name): HANK SUNG LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42104 HIGHWAY 195
HALEYVILLE AL
35565-7053
US

IV. Provider business mailing address

PO BOX 599
HALEYVILLE AL
35565-0599
US

V. Phone/Fax

Practice location:
  • Phone: 205-485-7284
  • Fax: 205-486-1903
Mailing address:
  • Phone: 205-485-7284
  • Fax: 205-485-7392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberAL7617
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAL7617
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: