Georgia Interventional And Vascular Specialists, PC
Phlebology in Atlanta, GA. Organization (NPI-2).
NPI number1255683470
StatusActive
Last updated in NPPESFeb 8, 2022
Details
- NPI
- 1255683470
- Entity type
- Organization (NPI-2)
- Legal business name
- Georgia Interventional And Vascular Specialists, PC
- Organization subpart
- No
- Enumeration date
- Oct 11, 2012
- Certification date
- Feb 8, 2022
- Last updated
- Feb 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 202K00000X | Phlebology | 042261 | GA | Yes |
| 207R00000X | Internal Medicine | 042261 | GA | |
| 208600000X | Surgery | – | – |
Practice location
264 19th St Nw Ste 2240Atlanta, GA 30363-1139
Phone 404-532-1564 · Fax 404-532-1565
Mailing address
2015 Spring Rd Ste 300Oak Brook, IL 60523-3944
Phone 630-725-2700
Authorized official
Cynthia Jones
Credentialing
6307252737
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