Provider Demographics
NPI:1033415476
Name:CENTER FOR PULMONARY & SLEEP MEDICINE, PLC
Entity Type:Organization
Organization Name:CENTER FOR PULMONARY & SLEEP MEDICINE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SRIRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNASAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-542-2647
Mailing Address - Street 1:PO BOX 30805
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-0014
Mailing Address - Country:US
Mailing Address - Phone:931-542-2647
Mailing Address - Fax:931-542-2648
Practice Address - Street 1:298 CLEAR SKY CT
Practice Address - Street 2:STE B
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5685
Practice Address - Country:US
Practice Address - Phone:931-542-2647
Practice Address - Fax:931-542-2648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34189207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty