# VASCULAR LABORATORY ASSOCIATES

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

## Provider details

- **NPI number:** 1750346912
- **Authorized official:** JAMES VAN HEEST MD (PRESIDENT)
- **Authorized official phone:** (414) 258-5130

## Contact information

- **Practice address:** 5000 W CHAMBERS ST, MILWAUKEE, WI 53210-1650
- **Practice address phone:** (414) 427-7820
- **Mailing address:** PO BOX 934, HALES CORNERS, WI 53130-0934
- **Mailing address phone:** (414) 427-7820

## Taxonomy

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

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 10/25/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 32714200 | — | WI |
| 01 | — | CG2325 | RR MEDICARE | WI |