institution
South Georgia Vascular Clinic
Vascular Surgery Physician in Tifton, Georgia
NPI 1144454059

South Georgia Vascular Clinic is a Vascular Surgery Physician based in Tifton, GA and is specialized in Vascular Surgery. South Georgia Vascular Clinic practices in Tifton, GA. The NPI Number for South Georgia Vascular Clinic is 1144454059 and holds a License No. 031466 (Georgia).

The current practice location address for South Georgia Vascular Clinic is 901 18Th St E, Tifton, GA and can be reached out via phone at 229-382-9733 and via fax at 229-387-6161.

Location: 901 18Th St E, Tifton, GA, 31794-3648
institution
Provider Profile Details
NPI Number
1144454059
Provider Name
South Georgia Vascular Clinic
Credential
Provider Entity Type
Organization
Address
901 18Th St E, Tifton, GA, 31794-3648
Phone Number
229-382-9733
Fax Number
229-387-6161
Provider Enumeration Date
05/06/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1003883612 01 GA NPI/WILLIAM KAISER, MD
1154356889 01 GA NPI/BRAD HOLT PA
205810921C 05 GA
institution
Provider Business Practice Location Address Details
Address
901 18Th St E
City
State
Zip
31794-3648
Phone Number
229-382-9733
Fax Number
229-387-6161
person
Provider Business Mailing Address Details
Address
901 18Th St E
City
State
Zip
31794-3648
Phone Number
229-382-9733
Fax Number
229-387-6161
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
License No.
031466 (Georgia)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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