Provider Demographics
NPI:1689814626
Name:LUNG CENTER OF DUBLIN
Entity Type:Organization
Organization Name:LUNG CENTER OF DUBLIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AYN
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:BAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-275-0792
Mailing Address - Street 1:PO BOX 16190
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31040-6190
Mailing Address - Country:US
Mailing Address - Phone:478-275-0792
Mailing Address - Fax:478-275-0713
Practice Address - Street 1:200 FAIRVIEW PARK DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2547
Practice Address - Country:US
Practice Address - Phone:478-275-0792
Practice Address - Fax:478-275-0713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055470207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty