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Organization
ADVANCED VASCULAR AND VEIN ASSOCIATES, LLC
Active
Organization
ADVANCED VASCULAR AND VEIN ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACHELLE GRIFFIN (CREDENTIALING MANAGER)
(769) 208-4437
Entity
Organization
Contact information
Practice address
4436 MANGUM DR, FLOWOOD, MS 39232-2113
(601) 586-7070
(601) 586-7071
Mailing address
4436 MANGUM DR, FLOWOOD, MS 39232-2113
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
NULL
2086S0129X
Vascular Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/01/2021
Last updated
10/23/2024
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