Provider Demographics
NPI:1376653923
Name:LUNG DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:LUNG DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAMANA
Authorized Official - Middle Name:P
Authorized Official - Last Name:PAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-436-6688
Mailing Address - Street 1:801 13TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1345
Mailing Address - Country:US
Mailing Address - Phone:229-436-6688
Mailing Address - Fax:229-436-0307
Practice Address - Street 1:801 13TH AVE STE A
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1345
Practice Address - Country:US
Practice Address - Phone:229-436-6688
Practice Address - Fax:229-436-0307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037052174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3216Medicare ID - Type UnspecifiedGROUP NUMBER