Provider Demographics
NPI:1821129560
Name:PULMONARY MEDICINE ASSOCIATES
Entity Type:Organization
Organization Name:PULMONARY MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-230-8505
Mailing Address - Street 1:850 OLIVE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-2162
Mailing Address - Country:US
Mailing Address - Phone:318-222-3662
Mailing Address - Fax:318-222-0034
Practice Address - Street 1:850 OLIVE ST
Practice Address - Street 2:SUITE A
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-2162
Practice Address - Country:US
Practice Address - Phone:318-222-3662
Practice Address - Fax:318-222-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty