Basic Information
| Provider Information | |||||||||
| NPI: | 1902092984 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GRANT PULMONARY PHYSICIANS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 S GRANT AVE | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432154701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145669143 | ||||||||
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| Address1: | 111 S GRANT AVE | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432154701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145669143 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2007 | ||||||||
| LastUpdateDate: | 09/24/2007 | ||||||||
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| AuthorizedOfficialLastName: | HAWLEY | ||||||||
| AuthorizedOfficialFirstName: | PHILIP | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6145669143 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.