| Organization Name: | SOUTHEAST LUNG AND CRITICAL CARE SPECIALIST |
| NPI Number: | 1871787069 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER W, STRICKLAND (FINANICAL OFFICER) |
| Mailing Address: | 405 E Long St Claxton |
| State: | GA US |
| Postal Code: | 304171443 |
| Phone Number: | 9128195757 |
| Fax Number: | 9128195753 |
| NPI Enumeration Date: | 08/30/2007 |
| NPI Last Update Date: | 02/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1200X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Sleep Disorder Diagnostic |
| Taxonomy Definition: | |