Organization · Type 2 NPI

Statesville Hma Medical Group, LLC

Vascular Surgery Physician · Statesville, NC

NPI number 1548544984 Active

Practice location

1703 Davie Ave
Statesville, NC 28677-3521

Call (704) 978-2271 Map

Fax (704) 978-2478

Mailing address

4000 Meridian Blvd
Franklin, TN 37067-6325

Specialties and licenses

Taxonomy	Code	License
Vascular Surgery Physician Primary	2086S0129X	None listed

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

4 other providers at this address

Other vascular surgery physician providers in Statesville

Iredell Physician Network LLCVascular Surgery Physician Statesville, NC NPI 1801475165

See all in Statesville →

NPI record

NPI: 1548544984
Entity type: Organization (Type 2)
Issued: Oct 4, 2011
Last updated: Jan 14, 2022
Status: Active
Subpart: Yes of Statesville Hma Medical Group LLC

Other names

<unavail>
Davis Vascular Institute · doing business as
Davis Vascular Institute · doing business as

Authorized official

Mrs. Jennifer L Jackson
SR Dir Prov Enrollment & Onboarding
(615) 465-3334

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1548544984

Statesville Hma Medical Group, LLC's National Provider Identifier is 1548544984, issued on Oct 4, 2011. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Statesville, NC. The record was last updated on Jan 14, 2022.