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
122 SCRANTON CONNECTOR, SUITE #112, BRUNSWICK, GA 31525-0533
(912) 629-2290
(912) 629-2291
Mailing address
340 HODGSON CT, SUITE #2, SAVANNAH, GA 31406-1520
(912) 629-2290
(912) 629-2291
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000148519L
—
GA
05
—
000272709E
—
GA
05
—
0004733833F
—
GA
05
—
000526336A
—
GA
05
—
000788818L
—
GA
05
—
000914922A
—
GA
05
—
003112189A
—
GA
05
—
003124134C
—
GA
05
—
003126241A
—
GA
05
—
003129391A
—
GA
05
—
003129392A
—
GA
05
—
003134446A
—
GA
05
—
003137375A
—
GA
05
—
221012519B
—
GA
05
—
487007710A
—
GA
05
—
696088793A
—
GA
05
—
795377228A
—
GA
Enumeration date
02/06/2014
Last updated
02/06/2014
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