Vascular Lab of Central Georgia LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

VASCULAR LAB OF CENTRAL GEORGIA LLC

Practice address

688 Walnut St
201
Macon, GA 31201-2677

Phone

(478) 254-7353

NPI assigned

Jul 5, 2016

Last updated

Jul 5, 2016By 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

Christine Rudd

Title

Practice Manager

Phone

(478) 254-7353

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1720430630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 WALNUT ST",
            "address_2": "201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 WALNUT ST",
            "address_2": "201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012677",
            "telephone_number": "478-254-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR LAB OF CENTRAL GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "478-254-7353"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Michelle Vanwyck-Smith, SLP.D., CCC
• Daniel Varga Jr., CP-C, NREMT-P, HC
• Devin Vargas
• Vascular Access Center of Georgia LLC
• Vascular and Interventional Radiology Associates of Central Ga
• Justin Vaughan, M.D.
• Danny M Vaughn, MD
• Jodi Marlisa Vaughn, APRN, PMHNP-BC
• Mary Bell Hancock Vaughn, M.D.
• Maria Guadalupe Vazquez de Santos, MD

• Ambulatory Surgical Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.