Organization · NPI-2

Nuvena Vein Clinic

Phlebology · Madison, MS

NPI number1679061469
StatusActive
Last updated in NPPESApr 26, 2018

Details

NPI
1679061469
Entity type
Organization (NPI-2)
Legal business name
Nuvena Vein Clinic
Organization subpart
No
Enumeration date
Apr 26, 2018
Last updated
Apr 26, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
202K00000X Phlebology13236MSYes
207L00000X Anesthesiology–MS

Practice location

120 Fountains Blvd
Madison, MS 39110

Phone 601-667-4405 · Fax 601-667-4406

Mailing address

107 Rosedowne Bend
Madison, MS 39110

Authorized official

Clifford C Adams
Owner
6015063366

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