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NPI Code Detail

MEDICARE: VASCULAR SURGICAL ASSOCIATES, PC

MEDICARE: VASCULAR SURGICAL ASSOCIATES, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic Supplier

General Provider Information

NPI Number : 1265921183
Entity Type Code : Organization
Provider Name (Legal Business Name) : VASCULAR SURGICAL ASSOCIATES, PC
Provider Business Mailing Address
First Line : 60 CHASTAIN CENTER BLVD NW STE 66
Second Line :
City : KENNESAW
State : GA
Zip : 30144-5598
Country : US
Telephone Number : 770-423-0595
Fax Number :
Provider Business Practice Location Address
First Line : 2041 MESA VALLEY WAY STE 185
Second Line :
City : AUSTELL
State : GA
Zip : 30106-6856
Country : US
Telephone Number : 770-944-8315
Fax Number :
Authorized Official
Title or Position : MGR
Name : RACHEL RAYES
Credential :
Telephone Number : 770-423-0595
Provider Enumeration Date : 05/07/2018
Last Update Date : 07/14/2025

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