Provider Demographics
NPI:1104161843
Name:CHRISTUS HEALTH AND LUNN PULMONOLOGY
Entity type:Organization
Organization Name:CHRISTUS HEALTH AND LUNN PULMONOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WILBURN
Authorized Official - Last Name:LUNN
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:318-798-4484
Mailing Address - Street 1:PO BOX 52311
Mailing Address - Street 2:CHRISTUS HEALTH AND LUNN PULMONOLOGY
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71135-2311
Mailing Address - Country:US
Mailing Address - Phone:318-798-4664
Mailing Address - Fax:318-798-4457
Practice Address - Street 1:1455 E. BERT KOUNS, SUITE #202
Practice Address - Street 2:CHRISTUS HEALTH AND LUNN PULMONOLOGY
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105
Practice Address - Country:US
Practice Address - Phone:318-798-4484
Practice Address - Fax:318-798-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204256207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty