Lee, Charles Ivy
Lee, Charles Ivy is an sole proprietor health care provider with primary practice located at 717 Pratt Ave Ne , Huntsville AL 35801-3645. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Addiction Medicine, Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, Residential Treatment Facilities / Substance Abuse Treatment, Children, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Lee, Charles Ivy can be contacted via phone (256) 808-2273.Contact Information
Primary practice address
717 Pratt Ave Ne
Huntsville AL 35801-3645
Phone: (256) 808-2273
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 00014864 | Alabama |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207LA0401X | 14864 | Alabama |
| Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children | 322D00000X | 14864 | Alabama |
| Residential Treatment Facilities / Substance Abuse Treatment, Children | 3245S0500X | 14864 | Alabama |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 14864 | Alabama |
Profile Details
| NPI number | 1255310363 |
|---|---|
| LBN Legal business name | Lee, Charles Ivy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Mar 19th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255310363 | NPPES |
| Alabama | MEDICAID | 000024029 | |
| Alabama | Other | 51024029 | |
| Alabama | Other | 51523698 | |
| Alabama | MEDICAID | 009975795 | |
| Alabama | Other | 051019925 |
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