Provider Demographics
NPI:1659501906
Name:SEC LUNG LLC
Entity Type:Organization
Organization Name:SEC LUNG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:GARVER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:888-681-5864
Mailing Address - Street 1:822 S THREE NOTCH ST
Mailing Address - Street 2:STE B
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5310
Mailing Address - Country:US
Mailing Address - Phone:888-681-5864
Mailing Address - Fax:334-222-6633
Practice Address - Street 1:822 S THREE NOTCH ST
Practice Address - Street 2:STE B
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5310
Practice Address - Country:US
Practice Address - Phone:888-681-5864
Practice Address - Fax:334-222-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty