Provider Demographics
NPI:1992717599
Name:EAST TENNESSEE PULMONARY ASSOCIATES PC
Entity type:Organization
Organization Name:EAST TENNESSEE PULMONARY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:R
Authorized Official - Middle Name:HAL
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-483-3594
Mailing Address - Street 1:800 OAK RIDGE TPKE
Mailing Address - Street 2:JACKSON PLAZA SUITE C-200
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6957
Mailing Address - Country:US
Mailing Address - Phone:865-483-3594
Mailing Address - Fax:865-483-4910
Practice Address - Street 1:800 OAK RIDGE TPKE
Practice Address - Street 2:JACKSON PLAZA SUITE C-200
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6957
Practice Address - Country:US
Practice Address - Phone:865-483-3594
Practice Address - Fax:865-483-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3380677Medicare ID - Type Unspecified