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SOUTHEASTERN LUNG CARE PC NPI 1235114430


NPI Information

NPI: 1235114430
Provider Name: SOUTHEASTERN LUNG CARE PC

Doing Business As: THE SLEEP DISORDERS CENTERS OF SOUTHEASTERN LUNG CARE

Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

CLIA Number: 11D1091811

Address:
1490 MILSTEAD RD NE STE A
CONYERS, GA
ZIP 30012
Phone: (770) 922-2217
Get Directions

SOUTHEASTERN LUNG CARE PC is a pulmonary disease internal medicine in Conyers, 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. SOUTHEASTERN LUNG CARE PC NPI is 1235114430. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As The Sleep Disorders Centers Of Southeastern Lung Care.

The provider's business location address is:

1490 MILSTEAD RD NE STE A
CONYERS, GA
ZIP 30012-823
Phone: (770) 922-2217
Fax: (770) 922-1626

The provider's authorized official is Andrea Lynn Discordia .
The authorized official title is Ceo Administrator and has the following contact phone number (404) 294-4018.

The CLIA number assigned to this NPI record is 11D1091811 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/9/2005 and was last updated on 3/6/2019.


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
1400116OTHERGEORGIABLUE CROSS BLUE SHIELD
255001212AMEDICAIDGEORGIA

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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