Provider Demographics
NPI:1528260858
Name:SOUTHWEST OHIO PULMONARY AND SLEEP SPECIALISTS INC
Entity type:Organization
Organization Name:SOUTHWEST OHIO PULMONARY AND SLEEP SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-867-4191
Mailing Address - Street 1:1010 CEREAL AVE
Mailing Address - Street 2:201
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-2784
Mailing Address - Country:US
Mailing Address - Phone:513-867-4191
Mailing Address - Fax:513-867-3159
Practice Address - Street 1:1010 CEREAL AVE
Practice Address - Street 2:201
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2784
Practice Address - Country:US
Practice Address - Phone:513-867-4191
Practice Address - Fax:513-867-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty