Organization
SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC
Active
Other names
Southeast Lung Associates
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL YOUNG (PRACTICE ADMINISTRATOR)
(912) 629-0457
Entity
Organization
Contact information
Practice address
105 E TOLLISON ST, # A, BAXLEY, GA 31513-0149
(912) 927-6270
(912) 927-6254
Mailing address
PO BOX 14417, SAVANNAH, GA 31416-1417
(912) 927-6270
(912) 927-6254
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000788818L
—
GA
05
—
003124134C
—
GA
05
—
003126241A
—
GA
05
—
003129391A
—
GA
05
—
003129392A
—
GA
05
—
003134446A
—
GA
05
—
003137375A
—
GA
05
—
221012519B
—
GA
05
—
795377228A
—
GA
Enumeration date
01/07/2014
Last updated
05/02/2014
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