COMPREHENSIVE VASCULAR SURGERY OF GEORGIA NPI 1902864291

NPI Information

NPI: 1902864291
Provider Name: COMPREHENSIVE VASCULAR SURGERY OF GEORGIA
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
150 COUNTRY CLUB DR
SUITE 100
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 474-3882
Get Directions

COMPREHENSIVE VASCULAR SURGERY OF GEORGIA is a vascular surgery surgery in Stockbridge, 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. COMPREHENSIVE VASCULAR SURGERY OF GEORGIA NPI is 1902864291. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

150 COUNTRY CLUB DR
SUITE 100
STOCKBRIDGE, GA
ZIP 30281-344
Phone: (770) 474-3882
Fax: (770) 474-9392

The provider's authorized official is Pearl E Asche Crowe .
The authorized official title is Practice Coordinator and has the following contact phone number (770) 474-3882.

The enumeration date for this NPI number is 5/3/2006 and was last updated on 6/28/2013.

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	263703	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	300030828A	MEDICAID	GEORGIA
2	GRP3147	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	MEDICARE GROUP ID

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »