Organization
PLATEAU PULMONOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GNANARAJ JOSEPH MD (SOLE OWNER)
(931) 210-0274
Entity
Organization
Contact information
Practice address
421 S MAIN ST, CROSSVILLE, TN 38555-5048
(931) 210-0274
(931) 787-1503
Mailing address
1263 E DEER CREEK DR, CROSSVILLE, TN 38571-3258
(931) 210-0274
(931) 787-1503
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD38221
TN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD38221
TN
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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