STATESVILLE HMA MEDICAL GROUP LLC NPI 1548544984

NPI Information

  • NPI: 1548544984
  • Provider Name: STATESVILLE HMA MEDICAL GROUP, LLC
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Organization
  • Doing Business As: DAVIS VASCULAR INSTITUTE
  • Address: 1703 DAVIE AVE
    STATESVILLE, NC
    ZIP 28677
  • Phone: (704) 978-2271

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NPI Details

STATESVILLE HMA MEDICAL GROUP, LLC is a vascular surgery surgery in Statesville, NC. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. STATESVILLE HMA MEDICAL GROUP, LLC NPI is 1548544984. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Davis Vascular Institute.

The provider's business location address is:

1703 DAVIE AVE
STATESVILLE, NC
ZIP 28677-521
Phone: (704) 978-2271
Fax: (704) 978-2478

The provider's authorized official is Jennifer L Jackson .
The authorized official title is Sr Dir Prov Enrollment & Onboarding and has the following contact phone number (615) 465-3334.

The enumeration date for this NPI number is 10/4/2011 and was last updated on 1/14/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryYes

What is NPI?

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This page was last updated on: 3/30/2025

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