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General NPI Number Information
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NPI Number | 1902051592
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Entity Type | Organization
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Legal Business Name | CHARLES LEE M.D.
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 115 QUEENSBURY DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1501
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Country | US
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Telephone | 256-880-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 DEBORAH DR SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-1413
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Country | US
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Telephone | 256-990-7867
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JENNIE FRANKLIN
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Credential |
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Telephone | 256-880-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 14864
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 14864
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License Number State | AL
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