NPIMap

Organization Active NPI

Southest Lung & Critical Care Specialists

  • Sleep Specialist (PhD)
  • Tifton, GA
National Provider Identifier
1043521859
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Specialist (PhD)Taxonomy code 173F00000X
License
036358 Issued in GA
Legal business name
SOUTHEST LUNG & CRITICAL CARE SPECIALISTS
Practice address
1821B Old Ocilla Road
Tifton, GA 31794
Phone
(912) 354-6614
Fax
(912) 356-9078
NPI assigned
Jun 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James A Daly III, MD
Title
Ceo
Phone
(912) 354-6614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Specialist (PhD)Group: 193200000X MULTI-SPECIALTY GROUP 173F00000X 036358 GA Primary

Addresses

Primary practice location

1821B Old Ocilla Road
Tifton, GA 31794

Mailing address

340 Eisenhower Dr
Building 1500
Savannah, GA 31406-1600
Phone (912) 354-6614

Other identifiers 2

IdentifierTypeStateIssuer
CI9902OtherSCRAILROAD MEDICARE
CI7230OtherGARAILROAD MEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Southeast Lung Associates40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

1821 Old Ocilla Rd
Ste B
Tifton, GA 31794

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1043521859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR",
            "address_2": "BUILDING 1500",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061600",
            "telephone_number": "912-354-6614",
            "fax_number": "912-356-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821B OLD OCILLA ROAD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "912-354-6614",
            "fax_number": "912-356-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEST LUNG & CRITICAL CARE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "DALY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-354-6614",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Sleep Specialist, PhD",
            "state": "GA",
            "license": "036358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI9902",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI7230",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.