Provider Demographics
NPI:1174581144
Name:LUNG CONSULTANTS PLLC
Entity type:Organization
Organization Name:LUNG CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:OLUSOLA
Authorized Official - Middle Name:OLANREWAJU
Authorized Official - Last Name:OGUNTOLU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-315-0030
Mailing Address - Street 1:5543 EDMONDSON PIKE
Mailing Address - Street 2:#44
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-315-0030
Mailing Address - Fax:615-315-0102
Practice Address - Street 1:5716 HICKORY PLZ
Practice Address - Street 2:STE 200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-8546
Practice Address - Country:US
Practice Address - Phone:615-315-0030
Practice Address - Fax:615-315-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36290207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4043600Medicaid
TN5347585OtherAETNA
TN3381539Medicaid
TN3381539Medicare ID - Type Unspecified
TN4043600Medicaid