Organization
SOUTHSIDE PULMONARY & SLEEP CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM HANK WOOLDRIDGE (DIRECTOR OF OPERATIONS)
(317) 893-0888
Entity
Organization
Contact information
Practice address
1040 GREENWOOD SPRINGS BLVD, GREENWOOD, IN 46143-7975
(317) 893-0888
(317) 893-0815
Mailing address
1040 GREENWOOD SPRINGS BLVD, GREENWOOD, IN 46143-7975
(317) 893-0888
(317) 893-0815
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200530370
—
IN
Enumeration date
05/18/2007
Last updated
06/29/2010
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