SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS PC NPI 1922402122

NPI Information

NPI: 1922402122
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:
230 MEMORIAL DR
JESUP, GA
ZIP 31545
Phone: (912) 629-2290
Get Directions

SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC is a pulmonary disease internal medicine in Jesup, 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 1922402122. 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:

230 MEMORIAL DR
JESUP, GA
ZIP 31545-102
Phone: (912) 629-2290
Fax: (912) 629-2291

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 10/16/2014 and was last updated on 10/16/2014.

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
1	207RP1001X	Internal Medicine	Pulmonary Disease			Yes

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
1	000473833F	MEDICAID	GEORGIA
2	003137375A	MEDICAID	GEORGIA
3	003129391A	MEDICAID	GEORGIA
4	795377228A	MEDICAID	GEORGIA
5	202I502513	MEDICARE PIN	GEORGIA
6	97WCJQB	MEDICARE PIN	GEORGIA
7	003126241A	MEDICAID	GEORGIA
8	003129392A	MEDICAID	GEORGIA
9	2025036I60	MEDICARE PIN	GEORGIA
10	202I504201	MEDICARE PIN	GEORGIA
11	221012519B	MEDICAID	GEORGIA
12	202I500568	MEDICARE PIN	GEORGIA
13	50BBFCP	MEDICARE PIN	GEORGIA
14	202I974459	MEDICARE PIN	GEORGIA
15	202I975803	MEDICARE PIN	GEORGIA
16	29BDBZW	MEDICARE PIN	GEORGIA
17	000526336A	MEDICAID	GEORGIA
18	003124134C	MEDICAID	GEORGIA
19	29BDBXP	MEDICARE PIN	GEORGIA
20	003134446A	MEDICAID	GEORGIA
21	202I975623	MEDICARE PIN	GEORGIA

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

NPI Synchronization or Removal

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