Provider Demographics
NPI:1093739062
Name:LEE, DONNA L (OD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:L
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8425 US HWY 431
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-0007
Mailing Address - Country:US
Mailing Address - Phone:256-878-9027
Mailing Address - Fax:256-891-7855
Practice Address - Street 1:8425 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0167
Practice Address - Country:US
Practice Address - Phone:256-878-9027
Practice Address - Fax:256-891-7855
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALST-410TA319152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102380001OtherPALMETTO
AL102G413759OtherMEDICARE GROUP PTAN
AL000059564Medicaid
AL510-59564OtherBLUE CROSS
AL102G413759OtherMEDICARE GROUP PTAN
AL000059564Medicaid