Healthcare Provider Details

I. General information

NPI: 1700063930
Provider Name (Legal Business Name): VASCULAR ACCESS OF MEMPHIS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 GETWELL RD
MEMPHIS TN
38118-2205
US

IV. Provider business mailing address

PO BOX 306295
NASHVILLE TN
37230-6295
US

V. Phone/Fax

Practice location:
  • Phone: 901-369-8100
  • Fax:
Mailing address:
  • Phone: 901-317-7360
  • Fax: 901-317-7585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES V ELLIS
Title or Position: OWNER
Credential: M.D.
Phone: 901-412-2042