Provider Demographics
NPI:1972551000
Name:VASCULAR SURGERY ASSOC, P.C.
Entity Type:Organization
Organization Name:VASCULAR SURGERY ASSOC, P.C.
Other - Org Name:VEINSOLUTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:810-732-1620
Mailing Address - Street 1:5020 W BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2919
Mailing Address - Country:US
Mailing Address - Phone:810-732-1620
Mailing Address - Fax:810-732-8559
Practice Address - Street 1:5151 GATEWAY CTR
Practice Address - Street 2:SUITE 400
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3929
Practice Address - Country:US
Practice Address - Phone:810-232-3363
Practice Address - Fax:810-232-3602
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VASCULAR SURGERY ASSOC, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-04
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty