Provider Demographics
NPI:1699860346
Name:LUNG AND SLEEP SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:LUNG AND SLEEP SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZMI
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-216-0191
Mailing Address - Street 1:PO BOX 950173
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0173
Mailing Address - Country:US
Mailing Address - Phone:502-213-9036
Mailing Address - Fax:502-412-9178
Practice Address - Street 1:1850 STATE ST
Practice Address - Street 2:ATTN: SLEEP CLINIC
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4990
Practice Address - Country:US
Practice Address - Phone:812-949-5550
Practice Address - Fax:812-949-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36883207RP1001X
207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200862900 AMedicaid
KY65945966Medicaid
IN200862900 AMedicaid
KY00154Medicare PIN
IN248680Medicare PIN