Organization
ADVANCED VASCULAR AND VEIN ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACHELLE GRIFFIN (CREDENTIALING MANAGER)
(769) 208-4437
Entity
Organization
Contact information
Practice address
4436 MANGUM DR, FLOWOOD, MS 39232-2113
(601) 586-7070
(601) 586-7071
Mailing address
4436 MANGUM DR, FLOWOOD, MS 39232-2113
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2021
Last updated
10/23/2024
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