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WESTERN VASCULAR INSTITUTE PLLC NPI 1265521181


NPI Information

NPI: 1265521181
Provider Name: WESTERN VASCULAR INSTITUTE PLLC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

CLIA Number: 03D2138558

Address:
7165 E UNIVERSITY DR
SUITE 183
MESA, AZ
ZIP 85207
Phone: (480) 668-5000
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WESTERN VASCULAR INSTITUTE PLLC is a vascular surgery surgery in Mesa, AZ. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. WESTERN VASCULAR INSTITUTE PLLC NPI is 1265521181. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7165 E UNIVERSITY DR
SUITE 183
MESA, AZ
ZIP 85207-400
Phone: (480) 668-5000
Fax: (480) 668-5065

The provider's authorized official is Jill Tom .
The authorized official title is Credentialing Officer and has the following contact phone number (480) 668-5000.

The CLIA number assigned to this NPI record is 03D2138558 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 6/23/2015.


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
12086S0129XSurgeryVascular SurgeryARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1103899MEDICAIDARIZONA

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: 11/14/2023

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