1932934502 NPI number — GEORGIA PULMONARY INSTITUTE, LLC

Table of content: THOMAS ANTHONY BOVEE BA (NPI 1992079198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932934502 NPI number — GEORGIA PULMONARY INSTITUTE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEORGIA PULMONARY INSTITUTE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1932934502
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8735 DUNWOODY PL STE 5820
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30350-2995
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 SHERATON BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MACON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31210-1359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-300-2927
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/04/2024

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
478-300-2927

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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