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Organization

SOUTHERN VASCULAR SPECIALISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALBERT ISAAC RICHARDSON II M.D. (OWNER)
(229) 224-4858
Entity
Organization

Contact information

Practice address
505 GORDON AVE, THOMASVILLE, GA 31792-6645
(229) 224-4858
Mailing address
PO BOX 6010, THOMASVILLE, GA 31758-6010
(229) 224-4858

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
055328
GA

Other

Enumeration date
10/25/2016
Last updated
10/25/2016
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