Provider Demographics
NPI:1730101684
Name:PULMONARY ASSOCIATES OF MORRISTOWN
Entity Type:Organization
Organization Name:PULMONARY ASSOCIATES OF MORRISTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-587-0740
Mailing Address - Street 1:500 MCFARLAND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814
Mailing Address - Country:US
Mailing Address - Phone:423-587-0740
Mailing Address - Fax:423-581-0063
Practice Address - Street 1:500 MCFARLAND ST
Practice Address - Street 2:SUITE B
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814
Practice Address - Country:US
Practice Address - Phone:423-587-0740
Practice Address - Fax:423-581-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25075207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1205814605OtherNPI
TN1730101684OtherGRP NPI
1205814605OtherNPI
F84768Medicare UPIN