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Organization

SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC

Active
Other names
Southeast Lung Associates
Organization subpart
No

Provider details

NPI number
Authorized official
APRIL YOUNG (ADMINISTRATOR)
(912) 629-0457
Entity
Organization

Contact information

Practice address
370 PEACHTREE ST, JESUP, GA 31545-0244
(912) 629-2290
Mailing address
PO BOX 14417, SAVANNAH, GA 31416-1417

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
32635
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
36358
GA
363A00000X
Physician Assistant
007191
GA
363LA2100X
Acute Care Nurse Practitioner
RN181784
GA
363LF0000X
Family Nurse Practitioner
RN101700
GA

Other

Enumeration date
09/03/2015
Last updated
09/03/2015
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