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Organization

SOUTH ATLANTA VASCULAR INSTITUTE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID WILLIAM ALLISON MD (MANAGING MEMBER)
(770) 405-8496
Entity
Organization

Contact information

Practice address
4714 OAKLEIGH MANOR DR, POWDER SPRINGS, GA 30127-4923
(770) 688-5334
Mailing address
4714 OAKLEIGH MANOR DR, POWDER SPRINGS, GA 30127-4923
(770) 688-5334

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
70519
GA
2086S0129X
Vascular Surgery Physician
Primary
66855
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1386869535
TN
05
1598965006
GA
05
1760644355
MA
Enumeration date
05/24/2018
Last updated
05/24/2018
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