Provider Demographics
NPI:1396741120
Name:LUNG CENTER, PC
Entity type:Organization
Organization Name:LUNG CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:M.
Authorized Official - Middle Name:MOATAZ
Authorized Official - Last Name:TOBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-388-7944
Mailing Address - Street 1:1222 TROTWOOD AVE
Mailing Address - Street 2:STE 601
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-6410
Mailing Address - Country:US
Mailing Address - Phone:931-388-7944
Mailing Address - Fax:931-380-1833
Practice Address - Street 1:1222 TROTWOOD AVE
Practice Address - Street 2:STE 601
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6410
Practice Address - Country:US
Practice Address - Phone:931-388-7944
Practice Address - Fax:931-380-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15230174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty