Healthcare Provider Details

I. General information

NPI: 1376688614
Provider Name (Legal Business Name): LUNG AND SLEEP DISORDER INSTITUTE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 10/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 TURPEN CT SUITE B
SOMERSET KY
42503-3464
US

IV. Provider business mailing address

46 TURPEN CT SUITE B
SOMERSET KY
42503-3464
US

V. Phone/Fax

Practice location:
  • Phone: 606-679-0179
  • Fax: 606-679-2580
Mailing address:
  • Phone: 606-679-0179
  • Fax: 606-679-2580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number31007
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number31007
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANDRA K SCHULDHEISZ
Title or Position: OWNER
Credential: MD
Phone: 606-679-0179