Provider Demographics
NPI:1508443102
Name:LEE, SAMANTHA NOEL (MD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:NOEL
Last Name:LEE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SUN TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8643
Mailing Address - Country:US
Mailing Address - Phone:256-975-4291
Mailing Address - Fax:
Practice Address - Street 1:7101 US HIGHWAY 90 STE 103
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9510
Practice Address - Country:US
Practice Address - Phone:251-517-5800
Practice Address - Fax:251-517-5801
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ALMD.457832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program