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General NPI Number Information
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NPI Number | 1821730052
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Entity Type | Organization
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Legal Business Name | SPINE AND VASCULAR EXPOSURES LLC
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 1099 MEDICAL CENTER CIR
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City | MAYFIELD
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State | KY
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Zip | 42066-1179
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Country | US
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Telephone | 256-532-1888
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Fax |
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Provider Business Mailing Address
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Address Line | 224 TEAKWOOD DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-3456
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID E COLLINS
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Credential | MD
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Telephone | 606-205-8456
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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 |
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License Number State |
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