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General NPI Number Information
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NPI Number | 1457665234
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Entity Type | Organization
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Legal Business Name | NEWNAN LUNG AND SLEEP SPECIALISTS, P.C.
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 4000 SHAKERAG HL SUITE 302
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4047
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Country | US
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Telephone | 770-253-8088
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Fax | 770-253-8089
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Provider Business Mailing Address
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Address Line | 4000 SHAKERAG HL SUITE 302
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4047
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Country | US
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Telephone | 770-253-8088
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Fax | 770-253-8089
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | VIJAY PATEL
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Credential | M.D.
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Telephone | 770-253-8088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 035723
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License Number State | GA
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