Healthcare Provider Details

I. General information

NPI: 1831294198
Provider Name (Legal Business Name): ASSOCIATED VEIN SOLUTIONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 VALLEY FORGE RD SUITE 102
PHOENIXVILLE PA
19460-2691
US

IV. Provider business mailing address

1260 VALLEY FORGE RD SUITE 102
PHOENIXVILLE PA
19460-2691
US

V. Phone/Fax

Practice location:
  • Phone: 610-933-2444
  • Fax: 610-933-8520
Mailing address:
  • Phone: 610-933-2444
  • Fax: 610-933-8520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD043999L
License Number StatePA

VIII. Authorized Official

Name: DR. JOHN J FLANAGAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-933-2444