# GEORIA VASCULAR SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619036928
- **Authorized official:** MRS. LAVERNE W POINDEXTER RN, MBA (EXECUTIVE ADMINISTRATOR)
- **Authorized official phone:** (770) 270-5229

## Contact information

- **Practice address:** 1718 PEACHTREE ST NW, SUITE 260, ATLANTA, GA 30309-2452
- **Practice address phone:** (404) 350-9505
- **Practice address fax:** (404) 350-1611
- **Mailing address:** PO BOX 54157, ATLANTA, GA 30308-0157
- **Mailing address phone:** (404) 350-9505
- **Mailing address fax:** (404) 350-1611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 029071 | GA | Yes |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 08/22/2020