Organization
PHOENIX VEIN INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAO KENITH FANG MD (OWNER)
(602) 253-9168
Entity
Organization
Contact information
Practice address
1144 E MCDOWELL RD, SUITE 400, PHOENIX, AZ 85006-2664
(602) 253-9168
(602) 251-3126
Mailing address
1144 E MCDOWELL RD, SUITE 400, PHOENIX, AZ 85006-2664
(602) 253-9168
(602) 251-3126
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AZ
Enumeration date
07/09/2006
Last updated
08/22/2020
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