Provider Demographics
NPI:1205007333
Name:ALBANY VASCULAR SPECIALIST CENTER
Entity Type:Organization
Organization Name:ALBANY VASCULAR SPECIALIST CENTER
Other - Org Name:ALBANY VASCULAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:229-436-8535
Mailing Address - Street 1:PO BOX 71804
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-1804
Mailing Address - Country:US
Mailing Address - Phone:229-436-8535
Mailing Address - Fax:229-432-1904
Practice Address - Street 1:2300 DAWSON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2803
Practice Address - Country:US
Practice Address - Phone:229-436-8535
Practice Address - Fax:229-432-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0535032086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty