Modern Vascular Of Southaven, Llc

LBN: Modern Vascular Of Southaven, Llc
Modern Vascular Of Southaven, Llc is an health care organization with primary practice located at 55 Physicians Ln , Southaven MS 38671-9569. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Technologists, Technicians & Other Technical Service Providers / Vascular-Interventional Technology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is the primary health care specialty. Modern Vascular Of Southaven, Llc can be contacted via phone (662) 655-2136, or through Gampel, Yury via phone (818) 880-8605.

Contact Information

Primary practice address
55 Physicians Ln Southaven MS 38671-9569
Phone: (662) 655-2136
Fax: (662) 996-2214
Website:
Map and Directions
Authorized official contact:
Name: Gampel, Yury
Phone: (818) 880-8605

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X
Technologists, Technicians & Other Technical Service Providers / Vascular-Interventional Technology 2471V0106X

Profile Details

NPI number 1174171441
LBN Legal business name Modern Vascular Of Southaven, Llc
DBA Doing business as
Authorized official Gampel, Yury
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2019
Last updated Aug 29th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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