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General NPI Number Information
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NPI Number | 1033277991
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Entity Type | Organization
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Legal Business Name | VENOUS & ARTERIAL SURGERY CLINIC, LLC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 180 GREENBRIAR BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-7233
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Country | US
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Telephone | 985-893-5958
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Fax | 985-893-5902
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Provider Business Mailing Address
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Address Line | 180 GREENBRIAR BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-7233
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Country | US
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Telephone | 985-893-5958
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Fax | 985-893-5902
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Authorized Official
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Title or Position | PARTNER
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Name | GEORGE E BARNES
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Credential | MD
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Telephone | 985-893-5958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 03988R
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License Number State | LA
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