Effingham Vascular Center, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

EFFINGHAM VASCULAR CENTER, LLC

Practice address

613 Towne Park Dr W Ste 204
Rincon, GA 31326-5183

Phone

(912) 826-6771

Fax

(912) 295-5605

NPI assigned

Apr 8, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Fran Baker-Witt, RN, MBA, LNHA

Title

Ceo

Phone

(912) 754-0160

Specialties & licenses 1

Addresses

Other names 1

• Effingham Vascular Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1043773161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 HIGHWAY 119 SOUTH",
            "address_2": "ATTN.: CREDENTIALING",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "31329",
            "telephone_number": "912-754-0175",
            "fax_number": "912-754-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 TOWNE PARK DR W STE 204",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265183",
            "telephone_number": "912-826-6771",
            "fax_number": "912-295-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFINGHAM VASCULAR CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-08",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "BAKER-WITT",
        "authorized_official_first_name": "FRAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-754-0160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RN, MBA, LNHA"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Effingham Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Effingham Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kenneth M Eugene, MD
• Hunter A. Faircloth, M.D.
• Family and Children Support, Inc

• Vascular Surgery Physician in Rincon, GA
• Providers in Rincon, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.