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Contact Information

SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS
163 E TOLLISON ST
BAXLEY, GA31513-0120
 Phone: 912-354-6614
 Fax: 912-356-9078
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Sleep Specialist, PhD

173F00000X
Indicates primary specialty

NPI Profile & details for SOUTHEAST LUNG CRITICAL CARE SPECIALISTS · (Female)

NPI # 1053640367
Status Active
Credentials
Entity Individual
Enumeration date 12/15/2009
Last updated 12/15/2009 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 032635
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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