Meridian Arts Surgical Group Vascular Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MERIDIAN ARTS SURGICAL GROUP VASCULAR LAB, LLC

Doing business as

MASG Vascular Lab, LLC

Practice address

2111 14TH St
Meridian, MS 39301-4041

Phone

(601) 693-3834

Fax

(601) 484-3225

NPI assigned

Dec 15, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra J Funck, EFPM, CAPPM

Title

Director

Phone

(601) 485-4443

Specialties & licenses 1

Addresses

Other names 1

• MASG Vascular Lab, LLC Doing business as

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306822960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014041",
            "telephone_number": "601-693-3834",
            "fax_number": "601-484-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014041",
            "telephone_number": "601-693-3834",
            "fax_number": "601-484-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN ARTS SURGICAL GROUP VASCULAR LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FUNCK",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-485-4443",
        "authorized_official_credential": "EFPM, CAPPM"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MASG Vascular Lab, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Foundation, Inc. (Ochsner Total Care for Women)
• Medical Plaza Eye Clinic, P.a.
• Medivice Global LLC
• Medselect LLC
• Meridian Anesthesiology Group, Inc
• Meridian Cab Company, Inc
• Meridian Center for Oral and Facial Surgery,PLLC
• Meridian Community College
• Meridian Crna LLC
• Meridian Dental Associates

• Clinical Medical Laboratory in Meridian, MS
• Providers in Meridian, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.