# E TOWN LUNG SPECIALIST PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790797702
- **Authorized official:** AIJAZ A YAZDANI MD (MEDICAL DOCTOR)
- **Authorized official phone:** (270) 735-9066

## Contact information

- **Practice address:** 914 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2520
- **Practice address phone:** (270) 735-9066
- **Practice address fax:** (270) 735-9036
- **Mailing address:** 914 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2520
- **Mailing address phone:** (270) 735-9066
- **Mailing address fax:** (270) 735-9036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/12/2006
- **Last updated:** 08/11/2025