# SOUTHWEST ATLANTA VASCULAR CARE, LLC

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

## Provider details

- **NPI number:** 1861933178
- **Authorized official:** LISA MCNAMARA (EVP)
- **Authorized official phone:** (239) 597-2010

## Contact information

- **Practice address:** 3885 PRINCETON LAKES WAY SW, SUITE 314, ATLANTA, GA 30331-5589
- **Practice address phone:** (404) 349-7770
- **Practice address fax:** (404) 349-7778
- **Mailing address:** 9140 CORSEA DEL FONTANA WAY, NAPLES, FL 34109-4397
- **Mailing address phone:** (239) 597-2010
- **Mailing address fax:** (239) 597-2313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/20/2017
- **Last updated:** 03/20/2017