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Organization

VCP NASHVILLE, LLC

Active
Other names
Vein Care Pavilion of Nashville
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN M ROTH M.D. (SOLE MEMBER/PRESIDENT)
(706) 854-3333
Entity
Organization

Contact information

Practice address
2222 STATE ST, STE 200B-1, NASHVILLE, TN 37203-1845
(615) 329-0029
Mailing address
4350 TOWNE CENTRE DR, STE 2000, EVANS, GA 30809-3301
(706) 854-3333

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
21108
TN
208200000X
Plastic Surgery Physician
26844
TN
2086S0129X
Vascular Surgery Physician
Primary
43956
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3370314
MEDICARE GROUP PTAN
TN
Enumeration date
05/12/2008
Last updated
05/23/2012
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