Provider Demographics
NPI:1174703227
Name:SOUTHWEST PULMONARY ASSOCIATES INC
Entity type:Organization
Organization Name:SOUTHWEST PULMONARY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-884-7272
Mailing Address - Street 1:5500 RIDGE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-2394
Mailing Address - Country:US
Mailing Address - Phone:440-884-7272
Mailing Address - Fax:440-884-7972
Practice Address - Street 1:7550 LUCERNE DR
Practice Address - Street 2:SUITE 405
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-6588
Practice Address - Country:US
Practice Address - Phone:800-556-6236
Practice Address - Fax:440-234-3313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050093207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9265371Medicare PIN