| Organization Name: | VCP 2 AUGUSTA PC |
| NPI Number: | 1124456306 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY VANN (CEO) |
| Mailing Address: | 4350 Towne Centre Dr Ste 2000b Evans |
| State: | GA US |
| Postal Code: | 308093301 |
| Phone Number: | 7068543333 |
| Fax Number: | 7068542149 |
| NPI Enumeration Date: | 10/24/2013 |
| NPI Last Update Date: | 10/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |