# ONE SOURCE VASCULAR

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ONE SOURCE VASCULAR
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1386433258
- **Legal business name:** ONE SOURCE VASCULAR
- **Authorized official:** DAVID P MURPHY DPM (MEDICAL DIRECTOR)
- **Authorized official phone:** (912) 283-6471

## Contact information

- **Practice address:** 2003B ALICE ST, WAYCROSS, GA 31501-6209
- **Practice address phone:** (912) 490-9420
- **Practice address fax:** (912) 514-9180
- **Mailing address:** 501 W ONEIDA ST, WAYCROSS, GA 31501-5337
- **Mailing address phone:** (912) 283-7596
- **Mailing address fax:** (912) 283-1618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/06/2025
- **Last updated:** 05/06/2025