Organization · NPI-2
Preferred Vascular Services Southeast LLC
· Lithonia, GA
NPI number1861992976
StatusActive
Last updated in NPPESFeb 6, 2026
Details
- NPI
- 1861992976
- Entity type
- Organization (NPI-2)
- Legal business name
- Preferred Vascular Services Southeast LLC
- Organization subpart
- No
- Enumeration date
- Feb 15, 2018
- Certification date
- Feb 6, 2026
- Last updated
- Feb 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0129X | – | – | Yes | |
| 2085R0204X | Radiology, Vascular & Interventional Radiology | – | – |
Practice location
5461 Hillandale Dr Ste 210Lithonia, GA 30058-4842
Phone 770-981-8477 · Fax 770-981-8908
Mailing address
9140 Corsea Del Fontana WayNaples, FL 34109-4397
Other practice locations
1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Stockbridge, GA 30281-5085
Phone 770-981-8477
Authorized official
Jennifer Boyd Baldock
Officer And Authorized Official
6152345954
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