Provider Demographics
NPI:1114019494
Name:LUNG CLINIC CENTER FOR SLEEP MEDICINE
Entity Type:Organization
Organization Name:LUNG CLINIC CENTER FOR SLEEP MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STRINGFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-471-6026
Mailing Address - Street 1:874 NE 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1635
Mailing Address - Country:US
Mailing Address - Phone:541-471-6026
Mailing Address - Fax:541-471-7051
Practice Address - Street 1:874 NE 7TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1635
Practice Address - Country:US
Practice Address - Phone:541-471-6026
Practice Address - Fax:541-471-7051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD16808207RC0200X, 207RP1001X
ORRTP000581227900000X
ORPA00609363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR009576Medicaid
ORR133191Medicare ID - Type UnspecifiedGROUP PRACTICE MEDICARE #
OR009576Medicaid