Provider Demographics
NPI:1932113925
Name:PIEDMONT PULMONARY CONSULTANTS PC
Entity Type:Organization
Organization Name:PIEDMONT PULMONARY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:KENNY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-352-3110
Mailing Address - Street 1:2001 PEACHTREE RD NE STE 600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1424
Mailing Address - Country:US
Mailing Address - Phone:404-352-3110
Mailing Address - Fax:404-352-4101
Practice Address - Street 1:2001 PEACHTREE RD NE STE 600
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1424
Practice Address - Country:US
Practice Address - Phone:404-352-3110
Practice Address - Fax:404-352-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017219207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP192Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER