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General NPI Number Information
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NPI Number | 1790515450
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Entity Type | Organization
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Legal Business Name | VASCULAR AND INTERVENTIONAL PARTNERS LAS VEGAS GOETTL PLLC
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Dates
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Enumeration Date | 08/06/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 2980 W HORIZON RIDGE PKWY
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City | HENDERSON
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State | NV
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Zip | 89052-4660
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Country | US
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Telephone | 725-291-3300
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Fax | 725-291-4848
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Provider Business Mailing Address
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Address Line | PO BOX 26630
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-0127
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Country | US
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Telephone | 725-291-3300
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Fax | 725-291-4848
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | CHRISTOPHER STEWART GOETTL
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Credential | MD
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Telephone | 267-334-9773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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