Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vascular and Vein Institute of the South, PLLC

Organization Vascular Surgery Physician · NPI 1073396453

Vascular and Vein Institute of the South, PLLC is a Vascular Surgery Physician in Memphis, Tennessee. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1653 Poplar Ave
Memphis, TN 38104-2511
Phone: (901) 390-2930
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X
Vascular Surgery Physician Taxonomy 2086S0129X
Podiatrist Taxonomy 213E00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1073396453
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationVascular and Vein Institute of the South PLLC
Authorized official Deona Deicke — Credentialing Specialist · (203) 641-9529
NPI enumeratedAugust 17, 2023
Last updated in NPPESAugust 17, 2023
Certification dateAugust 17, 2023
Mailing addressPo Box 386, Boynton Beach, FL 33425-0386

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