Healthcare Provider Details

I. General information

NPI: 1033679535
Provider Name (Legal Business Name): ALISON K LEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CLIFTON RD NE
ATLANTA GA
30322-5000
US

IV. Provider business mailing address

1525 CLIFTON RD NE
ATLANTA GA
30322-4200
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3333
  • Fax:
Mailing address:
  • Phone: 404-778-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number105445
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301511868
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number105445
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: