MEDICARE: PULMONOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558387787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULMONOLOGY INC

Provider Business Mailing Address
First Line	:	PO BOX 57006
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73157-7006
Country	:	US
Telephone Number	:	405-604-4990
Fax Number	:	404-604-4991

Provider Business Practice Location Address
First Line	:	5701 N PORTLAND AVE
Second Line	:	SUITE 225
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-1678
Country	:	US
Telephone Number	:	405-604-4990
Fax Number	:	405-604-4991

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NORMAN KERR IMES
Credential	:	M.D.
Telephone Number	:	405-604-4990

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	04/29/2012

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Directions to “PULMONOLOGY INC ” Practice Location

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