NPIMap

Organization Active NPI

Georgia Lung Associates PC

  • Pulmonary Disease Physician
  • Austell, GA
National Provider Identifier
1104989136
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
GEORGIA LUNG ASSOCIATES PC
Practice address
3820 Medical Park Drive
Austell, GA 30106-1110
Phone
(770) 948-6041
Fax
(770) 948-2736
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Mr. Anthony Broyles, CEO
Title
Ceo
Phone
(770) 948-6774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

3820 Medical Park Drive
Austell, GA 30106-1110

Mailing address

3820 Medical Park Drive
Austell, GA 30106-1110
Phone (770) 948-6041

National Provider Directory

National Provider Directory

Locations

535 Maxham Rd
Ste A
Austell, GA 30168
Phone (770) 948-6041

400 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 514-7550

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1104989136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MEDICAL PARK DRIVE",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "770-948-6041",
            "fax_number": "770-948-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MEDICAL PARK DRIVE",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "770-948-6041",
            "fax_number": "770-948-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA LUNG ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "BROYLES",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-948-6774",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.