# SOUTH GEORGIA VEIN CENTERS LLC

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

## Provider details

- **NPI number:** 1669405452
- **Authorized official:** GREGORY D MARTIN M.D. (PRESIDENT)
- **Authorized official phone:** (229) 259-9666

## Contact information

- **Practice address:** 3338 COUNTRY CLUB RD \# M, VALDOSTA, GA 31605-1044
- **Practice address phone:** (229) 259-9666
- **Practice address fax:** (229) 253-0064
- **Mailing address:** 3338 L1 COUNTRY CLUB RD PMB 342, VALDOSTA, GA 31605
- **Mailing address phone:** (229) 259-9666
- **Mailing address fax:** (229) 253-0064

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 10/07/2024