Organization
VASCULAR SPECIALISTS,PLLC
Active
Other names
surgical group psc
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIE STUBER (CODER)
(270) 441-4376
Entity
Organization
Contact information
Practice address
225 MEDICAL CENTER DR, SUITE 208R, PADUCAH, KY 42003-7914
(270) 441-4300
(270) 441-4370
Mailing address
PO BOX 7329, PADUCAH, KY 42002-7329
(270) 441-4300
(270) 441-4370
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65945537
—
KY
Enumeration date
06/29/2006
Last updated
05/07/2008
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