Provider Demographics
NPI:1336136779
Name:SUMMIT SLEEP AND LUNG ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:SUMMIT SLEEP AND LUNG ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRMINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-391-5567
Mailing Address - Street 1:3901 CENTRAL PIKE
Mailing Address - Street 2:SUITE 352
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3419
Mailing Address - Country:US
Mailing Address - Phone:615-391-5567
Mailing Address - Fax:615-391-5530
Practice Address - Street 1:3901 CENTRAL PIKE
Practice Address - Street 2:SUITE 352
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3419
Practice Address - Country:US
Practice Address - Phone:615-391-5567
Practice Address - Fax:615-391-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3726497Medicaid
TN3726497Medicare ID - Type Unspecified