Provider Demographics
NPI:1033148390
Name:PULMONARY DISEASE CLINIC, LLP
Entity Type:Organization
Organization Name:PULMONARY DISEASE CLINIC, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:KEARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-769-5864
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-769-5864
Mailing Address - Fax:225-766-8907
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 701
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-769-5864
Practice Address - Fax:225-766-8907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C030Medicare ID - Type UnspecifiedGROUP PRACTICE NUMBER