Organization
VICTORY VASCULAR & GENERAL SURGERY OF GEORGIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZEEZ POPOOLA ADEDUNTAN M.D (PRESIDENT)
(706) 227-0871
Entity
Organization
Contact information
Practice address
435 HAWTHORNE AVE, #600, ATHENS, GA 30606-2574
(706) 227-0871
(706) 227-0865
Mailing address
435 HAWTHORNE AVE, #600, ATHENS, GA 30606-2574
(706) 227-0871
(706) 227-0865
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
040293
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000670381C
—
GA
Enumeration date
03/13/2007
Last updated
01/24/2013
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