Provider Demographics
NPI:1548600877
Name:MARK A BENAK MD NASHVILLE PC
Entity Type:Organization
Organization Name:MARK A BENAK MD NASHVILLE PC
Other - Org Name:VEIN GUYS NASHVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-854-2138
Mailing Address - Street 1:4350 TOWNE CENTRE DR
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3301
Mailing Address - Country:US
Mailing Address - Phone:706-854-3333
Mailing Address - Fax:706-854-2149
Practice Address - Street 1:2222 STATE ST
Practice Address - Street 2:SUITE 200 B 1
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1845
Practice Address - Country:US
Practice Address - Phone:615-329-0029
Practice Address - Fax:615-891-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty