Provider Demographics
NPI:1932885613
Name:TOVAR VETENCOURT, ARIANNA ALICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIANNA
Middle Name:ALICIA
Last Name:TOVAR VETENCOURT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 TOPGOLF WAY APT 9406
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-0349
Mailing Address - Country:US
Mailing Address - Phone:786-570-8859
Mailing Address - Fax:
Practice Address - Street 1:1120 15H ST AUGUSTA UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0001
Practice Address - Country:US
Practice Address - Phone:706-721-2423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15233207R00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine