MODERN VASCULAR OF SOUTHAVEN, LLC – NPI #1174171441
Radiology

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

MODERN VASCULAR OF SOUTHAVEN, LLC is a radiologist located in SOUTHAVEN, MS. NPPES has assigned the NPI number 1174171441 to MODERN VASCULAR OF SOUTHAVEN, LLC on August 29, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2085R0204X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Vascular & Interventional Radiology

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MODERN VASCULAR OF SOUTHAVEN, LLC below.

NPI Profile for
MODERN VASCULAR OF SOUTHAVEN, LLC

NPI Number
1174171441
Enumeration Date

(about 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MODERN VASCULAR OF SOUTHAVEN, LLC
Primary location
55 PHYSICIANS LN
SOUTHAVEN, MS 38671-9569
Phone: (662) 655-2136 Fax: (662) 996-2214
Mailing address
26500 AGOURA RD STE 201
CALABASAS, CA 91302-3556
Phone: (818) 880-8605 Fax: (818) 579-7916
Organization Subpart
No
Authorized Official
YURY GAMPEL
MANAGER
Phone: (818) 880-8605
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.