Provider Demographics
NPI:1801974175
Name:GWINNETT PULMONARY GROUP
Entity type:Organization
Organization Name:GWINNETT PULMONARY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN IN CHARGE/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-995-0630
Mailing Address - Street 1:631 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-7651
Mailing Address - Country:US
Mailing Address - Phone:770-995-0630
Mailing Address - Fax:678-942-5984
Practice Address - Street 1:631 PROFESSIONAL DR STE 350
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3370
Practice Address - Country:US
Practice Address - Phone:770-995-0630
Practice Address - Fax:678-205-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA326200207QS1201X, 207R00000X, 207RC0200X, 207RP1001X
332900000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA555819545SAMedicare PIN