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VASCULAR SURGERY ASSOC P.C. NPI 1134366024


NPI Information

NPI: 1134366024
Provider Name: VASCULAR SURGERY ASSOC, P.C.

Other Name: CLARKSTON MICHIGAN VASCULAR

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

CLIA Number: 23D2122903

Address:
5701 BOW POINTE DR
SUITE 2010
CLARKSTON, MI
ZIP 48346
Phone: (248) 620-3900
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VASCULAR SURGERY ASSOC, P.C. is a vascular surgery surgery in Clarkston, MI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. VASCULAR SURGERY ASSOC, P.C. NPI is 1134366024. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Clarkston Michigan Vascular.

The provider's business location address is:

5701 BOW POINTE DR
SUITE 2010
CLARKSTON, MI
ZIP 48346-198
Phone: (248) 620-3900
Fax: (248) 620-5390

The provider's authorized official is Joseph Jacot .
The authorized official title is Business Administrator and has the following contact phone number (810) 732-1620.

The CLIA number assigned to this NPI record is 23D2122903 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/14/2009 and was last updated on 12/20/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular 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: 5/5/2024

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