VCP SOUTH LLC NPI 1811937402

NPI Information

NPI: 1811937402
Provider Name: VCP SOUTH, LLC

Doing Business As: VEIN CARE PAVILION OF THE SOUTH

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
4350 TOWNE CENTRE DR
STE 2000
EVANS, GA
ZIP 30809
Phone: (706) 854-3333
Get Directions

VCP SOUTH, LLC is a vascular surgery surgery in Evans, 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. VCP SOUTH, LLC NPI is 1811937402. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Vein Care Pavilion Of The South.

The provider's business location address is:

4350 TOWNE CENTRE DR
STE 2000
EVANS, GA
ZIP 30809-301
Phone: (706) 854-3333
Fax: (706) 396-0615

The provider's authorized official is Steven M Roth .
The authorized official title is Sole Member/president and has the following contact phone number (706) 854-3333.

The enumeration date for this NPI number is 6/8/2006 and was last updated on 5/23/2012.

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
1	2086S0129X	Surgery	Vascular Surgery	048566	GEORGIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GRP6892	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA
2	985661	OTHER	GEORGIA	BCBS
3	=========	OTHER	GEORGIA	COMMERCIAL INSURANCE

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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