Provider Demographics
NPI:1134472384
Name:THE LUNG CLINIC LLC
Entity Type:Organization
Organization Name:THE LUNG CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RATNAKANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-753-8361
Mailing Address - Street 1:PO BOX 440107
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0107
Mailing Address - Country:US
Mailing Address - Phone:901-753-8361
Mailing Address - Fax:901-756-8541
Practice Address - Street 1:6019 WALNUT GROVE RD.
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-0000
Practice Address - Country:US
Practice Address - Phone:901-753-8361
Practice Address - Fax:901-756-8541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39269207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty