Organization
THE VEIN INSTITUTE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT WAYNE GARDNER MD (OWNER)
(423) 551-8346
Entity
Organization
Contact information
Practice address
1405 COWART ST, STE 321, CHATTANOOGA, TN 37408-1127
(423) 551-8346
(423) 551-8347
Mailing address
1405 COWART ST, STE 321, CHATTANOOGA, TN 37408-1127
(423) 551-8346
(423) 551-8347
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103G700982
MEDICARE PTAN
TN
Enumeration date
12/14/2015
Last updated
04/14/2016
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