Organization
VASCULAR AND VEIN INSTITUTE OF THE SOUTH, PLLC
Active
Parent organization
VASCULAR AND VEIN INSTITUTE OF THE SOUTH PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VASCULAR AND VEIN INSTITUTE OF THE SOUTH PLLC
Authorized official
DEONA DEICKE (CREDENTIALING SPECIALIST)
(203) 641-9529
Entity
Organization
Contact information
Practice address
1653 POPLAR AVE, MEMPHIS, TN 38104-2511
(901) 390-2930
Mailing address
PO BOX 386, BOYNTON BEACH, FL 33425-0386
(203) 641-9529
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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