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PREFERRED VASCULAR SERVICES NORTHWEST LLC NPI 1598037822


NPI Information

NPI: 1598037822
Provider Name: PREFERRED VASCULAR SERVICES NORTHWEST, LLC

Former Legal Business Name: PREFERRED VASCULAR SERVICES OF GEORGIA, LLC

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

CLIA Number: 11D2198332

Address:
711 CANTON RD NE STE 220
MARIETTA, GA
ZIP 30060
Phone: (404) 554-2196
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PREFERRED VASCULAR SERVICES NORTHWEST, LLC is a vascular surgery surgery in Marietta, GA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. PREFERRED VASCULAR SERVICES NORTHWEST, LLC NPI is 1598037822. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Preferred Vascular Services Of Georgia, Llc.

The provider's business location address is:

711 CANTON RD NE STE 220
MARIETTA, GA
ZIP 30060-949
Phone: (404) 554-2196
Fax: (404) 554-2415

The provider's authorized official is Lisa A Mcnamara .
The authorized official title is Cfo and has the following contact phone number (239) 597-2010.

The CLIA number assigned to this NPI record is 11D2198332 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/1/2012 and was last updated on 9/6/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0204XRadiologyVascular & Interventional RadiologyNo
22086S0129XSurgeryVascular SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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