Organization
SOUTHEAST ATLANTA VASCULAR CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MCNAMARA (EVP)
(239) 597-2010
Entity
Organization
Contact information
Practice address
5461 HILLANDALE DR, SUITE 210, LITHONIA, GA 30058-4841
(770) 981-8477
(770) 981-8908
Mailing address
9140 CORSEA DEL FONTANA WAY, NAPLES, FL 34109-4397
(239) 597-2010
(239) 597-2313
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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