Healthcare Provider Details

I. General information

NPI: 1366139859
Provider Name (Legal Business Name): USA VEIN CLINICS OF TENNESSEE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020 OVERLOOK BLVD STE 150
BRENTWOOD TN
37027-2727
US

IV. Provider business mailing address

PO BOX 1602
NORTHBROOK IL
60065-1602
US

V. Phone/Fax

Practice location:
  • Phone: 615-401-7162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: FLORA KATSNELSON
Title or Position: OWNER
Credential:
Phone: 847-593-8460