# VASCULAR SURGERY ASSOC PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michigan Vascular Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710959150
- **Authorized official:** MR. JOSEPH JACOT MBA (BUSINESS ADMINISTRATOR)
- **Authorized official phone:** (810) 732-1620

## Contact information

- **Practice address:** 5020 W BRISTOL RD, FLINT, MI 48507-2919
- **Practice address phone:** (810) 732-1620
- **Practice address fax:** (810) 732-8559
- **Mailing address:** 5020 W BRISTOL RD, FLINT, MI 48507-2919
- **Mailing address phone:** (810) 732-1620
- **Mailing address fax:** (810) 732-8559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 02/01/2006
- **Last updated:** 12/20/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 020B560600 | BC/BS OF MICHIGAN | MI |