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Contact Information

SOUTHEST LUNG & CRITICAL CARE SPECIALISTS
1821B OLD OCILLA ROAD
TIFTON, GA31794
 Phone: 912-354-6614
 Fax: 912-356-9078
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sleep Specialist, PhD

173F00000X
Indicates primary specialty

NPI Profile & details for SOUTHEST LUNG & CRITICAL CARE SPECIALISTS

NPI Number 1043521859
LBN Legal business name SOUTHEST LUNG & CRITICAL CARE SPECIALISTS
Authorized official JAMES DALY - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/25/2010
Last updated 06/25/2010 - About 16 years ago
Identifiers
GA License # 036358
GA Other CI7230 RAILROAD MEDICARE
SC Other CI9902 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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