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Organization
THE VASCULAR CLINIC LLC
Active
Organization
THE VASCULAR CLINIC LLC
Active
Other names
Vascular Clinic of Northwest Georgia, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B SAAKA (OWNER)
(706) 858-0204
Entity
Organization
Contact information
Practice address
102 GROSS CRESCENT CIR, SUITE 204, FT OGLETHORPE, GA 30742-3600
(706) 858-0204
(706) 858-0225
Mailing address
102 GROSS CRESCENT CIR, SUITE 204, FT OGLETHORPE, GA 30742-3600
(706) 858-0204
(706) 858-0225
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143447302A
—
GA
05
—
3734225
—
TN
01
—
4176994
TENNESSE BLUE SHIELD
TN
Enumeration date
06/01/2006
Last updated
06/11/2008
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