Provider Demographics
NPI:1154441558
Name:KCS PULMONARY PC
Entity type:Organization
Organization Name:KCS PULMONARY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:SPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-591-0011
Mailing Address - Street 1:PO BOX 120605
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23612-0605
Mailing Address - Country:US
Mailing Address - Phone:757-591-0011
Mailing Address - Fax:
Practice Address - Street 1:11747 JEFFERSON AVE STE 3H
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4403
Practice Address - Country:US
Practice Address - Phone:757-591-0011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031028207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty