Provider Demographics
NPI:1457021438
Name:VASCULAR AND INTERVENTIONAL PARTNERS, LLC
Entity Type:Organization
Organization Name:VASCULAR AND INTERVENTIONAL PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOETTL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-334-9773
Mailing Address - Street 1:22455 N MILLER RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4956
Mailing Address - Country:US
Mailing Address - Phone:267-334-9773
Mailing Address - Fax:
Practice Address - Street 1:22455 N MILLER RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4956
Practice Address - Country:US
Practice Address - Phone:267-334-9773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ56081OtherMEDICAL LICENSE