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Organization
GEORGIA INTERVENTIONAL AND VASCULAR SPECIALISTS, PC
Active
Organization
GEORGIA INTERVENTIONAL AND VASCULAR SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA JONES (CREDENTIALING)
(630) 725-2737
Entity
Organization
Contact information
Practice address
264 19TH ST NW STE 2240, ATLANTA, GA 30363-1139
(404) 532-1564
(404) 532-1565
Mailing address
2015 SPRING RD STE 300, OAK BROOK, IL 60523-3944
(630) 725-2700
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
042261
GA
207R00000X
Internal Medicine Physician
042261
GA
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
10/11/2012
Last updated
02/08/2022
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