Provider Demographics
NPI:1972735892
Name:LAWRENCE I LEE MD LLC
Entity Type:Organization
Organization Name:LAWRENCE I LEE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-985-9023
Mailing Address - Street 1:120 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1185
Mailing Address - Country:US
Mailing Address - Phone:205-985-9023
Mailing Address - Fax:
Practice Address - Street 1:120 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1185
Practice Address - Country:US
Practice Address - Phone:205-985-9023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20235207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty