Provider Demographics
NPI:1518944834
Name:LEE, RONY R (MD)
Entity Type:Individual
Prefix:
First Name:RONY
Middle Name:R
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S ALSTON ST
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1914
Mailing Address - Country:US
Mailing Address - Phone:251-923-2050
Mailing Address - Fax:251-923-2051
Practice Address - Street 1:222 S ALSTON ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1914
Practice Address - Country:US
Practice Address - Phone:251-923-2050
Practice Address - Fax:251-923-2051
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23039207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51545830OtherBCBS
ALH06412Medicare UPIN
AL51545830OtherBCBS