Organization
PULMONARY ASSOCIATES OF KINGSPORT
Active
Other names
SLEEP EVALUATION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY HAWKINS (ADMINISTRATOR)
(423) 247-5197
Entity
Organization
Contact information
Practice address
2050 MEADOWVIEW PKWY, SUITE 205, KINGSPORT, TN 37660-7332
(423) 247-9075
(423) 245-7953
Mailing address
111 W STONE DR, SUITE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055800
ANTHEM
VA
05
—
3700107
—
TN
01
—
65906208
KENTUCKY MEDICAID
KY
01
—
85538
BLUE CROSS BLUE SHIELD
TN
Enumeration date
05/22/2006
Last updated
06/22/2010
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