Provider Demographics
NPI:1003348012
Name:VASCULAR ADVANTAGES OF LA, LLC
Entity Type:Organization
Organization Name:VASCULAR ADVANTAGES OF LA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-601-5501
Mailing Address - Street 1:10966 LAIRD LN
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-7963
Mailing Address - Country:US
Mailing Address - Phone:303-601-5501
Mailing Address - Fax:
Practice Address - Street 1:10966 LAIRD LN
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7963
Practice Address - Country:US
Practice Address - Phone:303-601-5501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty