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SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS PC NPI 1194064832


NPI Information

NPI: 1194064832
Provider Name: SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC

Doing Business As: SOUTHEAST LUNG ASSOCIATES

Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

Address:
209A MIMS RD
SYLVANIA, GA
ZIP 30467
Phone: (912) 826-3927
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SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC is a pulmonary disease internal medicine in Sylvania, GA. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC NPI is 1194064832. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southeast Lung Associates.

The provider's business location address is:

209A MIMS RD
SYLVANIA, GA
ZIP 30467-994
Phone: (912) 826-3927
Fax: (912) 826-3931

The provider's authorized official is April Young .
The authorized official title is Practice Administrator and has the following contact phone number (912) 629-0457.

The enumeration date for this NPI number is 1/31/2013 and was last updated on 7/17/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RP1001XInternal MedicinePulmonary DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1202I114674MEDICARE PINGEORGIA
2000788818LMEDICAIDGEORGIA
3000526336AMEDICAIDGEORGIA
4000914922AMEDICAIDGEORGIA
5696088793AMEDICAIDGEORGIA
629BDBZWMEDICARE PINGEORGIA
7202I294672MEDICARE PINGEORGIA
811BDWLVMEDICARE PINGEORGIA
929BDCFNMEDICARE PINGEORGIA
1029BDBXPMEDICARE PINGEORGIA
11487007710AMEDICAIDGEORGIA
12000148519LMEDICAIDGEORGIA
13000473833FMEDICAIDGEORGIA
1411SCHRFMEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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