Provider Demographics
NPI:1942359369
Name:TENNESSEE VALLEY LUNG CARE, PC
Entity Type:Organization
Organization Name:TENNESSEE VALLEY LUNG CARE, 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:P
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-232-0667
Mailing Address - Street 1:27669 CAPSHAW RD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-7403
Mailing Address - Country:US
Mailing Address - Phone:256-232-0667
Mailing Address - Fax:256-232-0557
Practice Address - Street 1:27669 CAPSHAW RD.
Practice Address - Street 2:A2
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-7403
Practice Address - Country:US
Practice Address - Phone:256-232-0667
Practice Address - Fax:256-232-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16579207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51002887OtherBCBS
AL009934453Medicaid
AL5163648OtherAETNA
AL051557116Medicare ID - Type Unspecified
AL5163648OtherAETNA