Organization
VASCULAR LABORATORY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES VAN HEEST MD (PRESIDENT)
(414) 258-5130
Entity
Organization
Contact information
Practice address
5000 W CHAMBERS ST, MILWAUKEE, WI 53210-1650
(414) 427-7820
Mailing address
PO BOX 934, HALES CORNERS, WI 53130-0934
(414) 427-7820
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32714200
—
WI
01
—
CG2325
RR MEDICARE
WI
Enumeration date
04/19/2006
Last updated
10/25/2007
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