Modern Vascular of Southaven, LLC
Modern Vascular of Southaven, LLC is a Vascular & Interventional Radiology Physician in Southaven, Mississippi. Registered with an NPI since 2019.
- In the registry since
- 2019
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
55 Physicians LnSouthaven, MS 38671-9569
Phone: (662) 655-2136
Fax: (662) 996-2214
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Vascular & Interventional Radiology Physician (primary) | Taxonomy 2085R0204X |
|---|---|
| Vascular-Interventional Technology Radiologic Technologist | Taxonomy 2471V0106X |
Record details
| NPI number | 1174171441 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Yury Gampel — Manager · (818) 880-8605 |
| NPI enumerated | August 29, 2019 |
| Last updated in NPPES | August 29, 2019 |
| Mailing address | 26500 Agoura Rd Ste 201, Calabasas, CA 91302-3556 |
Other providers in Southaven
-
Trm Endovascular & Wound Care Services LLC
7900 Airways Blvd Ste 6, Southaven, MS 38671-4113 · (662) 470-7554