Provider Demographics
NPI:1790887545
Name:THE LUNG CENTER, PC
Entity Type:Organization
Organization Name:THE LUNG CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDSEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:256-767-5864
Mailing Address - Street 1:3905 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2803
Mailing Address - Country:US
Mailing Address - Phone:256-767-5864
Mailing Address - Fax:256-263-4512
Practice Address - Street 1:3905 PEACH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2803
Practice Address - Country:US
Practice Address - Phone:256-767-5864
Practice Address - Fax:256-263-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2023-11-10
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
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529912730Medicaid