Individual
CHARLES IVY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4025 PEPPERWOOD CIR SW STE C, HUNTSVILLE, AL 35801-7438
(256) 715-8193
(256) 715-8195
Mailing address
4025 PEPPERWOOD CIR SW STE C, HUNTSVILLE, AL 35801-7438
(256) 715-8193
(256) 715-8195
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
00014864
AL
207LA0401X
Addiction Medicine (Anesthesiology) Physician
14864
AL
208D00000X
General Practice Physician
Primary
14864
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000024029
—
AL
05
—
009975795
—
AL
01
—
051019925
BCBS- AL INDIV
AL
01
—
51024029
BCBS HH LOCATIONS
AL
01
—
51523698
BCBS MADISON SURG CTR
AL
Enumeration date
01/17/2006
Last updated
02/18/2026
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