Organization
VCP SOUTH, LLC
Active
Other names
Vein Care Pavilion of the South
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
4350 TOWNE CENTRE DR, STE 2000, EVANS, GA 30809-3301
(706) 854-3333
(706) 396-0615
Mailing address
4350 TOWNE CENTRE DR, STE 2000, EVANS, GA 30809-3301
(706) 854-3333
(706) 396-0615
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
048566
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
985661
BCBS
GA
Enumeration date
06/08/2006
Last updated
05/23/2012
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