# PREMIER VASCULAR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Vascular Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942981618
- **Authorized official:** JONATHAN CUDNIK (MEMBER)
- **Authorized official phone:** (478) 250-9785

## Contact information

- **Practice address:** 1902 FORSYTH ST, MACON, GA 31201-8132
- **Practice address phone:** (478) 250-9785
- **Practice address fax:** (478) 202-9505
- **Mailing address:** 451 COLLEGE ST UNIT 13025, MACON, GA 31208-3009
- **Mailing address fax:** (478) 202-9505

## Taxonomy

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

## Other

- **Enumeration date:** 07/26/2023
- **Last updated:** 06/06/2025