# GEORGIA VASCULAR INSTITUTE, LLC

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

## Provider details

- **NPI number:** 1912136524
- **Authorized official:** HOLLY FARROW (COO)
- **Authorized official phone:** (770) 506-4007

## Contact information

- **Practice address:** 3886 PRINCETON LAKES WAY SW STE 100, ATLANTA, GA 30331-5511
- **Practice address phone:** (770) 506-4007
- **Practice address fax:** (678) 623-3543
- **Mailing address:** 3886 PRINCETON LAKES WAY SW STE 100, ATLANTA, GA 30331-5511
- **Mailing address phone:** (770) 506-4007
- **Mailing address fax:** (678) 623-3543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/06/2009
- **Last updated:** 12/16/2021