Provider Demographics
NPI:1447326269
Name:VASCULAR SURGEONS OF SANDUSKY INC
Entity type:Organization
Organization Name:VASCULAR SURGEONS OF SANDUSKY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOWZELL
Authorized Official - Middle Name:MEDFORD
Authorized Official - Last Name:SWAYNGIM
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:419-625-0599
Mailing Address - Street 1:703 TYLER ST
Mailing Address - Street 2:SUITE 251
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3367
Mailing Address - Country:US
Mailing Address - Phone:419-625-0599
Mailing Address - Fax:419-625-3704
Practice Address - Street 1:703 TYLER ST
Practice Address - Street 2:SUITE 251
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3367
Practice Address - Country:US
Practice Address - Phone:419-625-0599
Practice Address - Fax:419-625-3704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0414262086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty