MODERN VASCULAR OF SOUTHAVEN, LLC
NPI 1174171441
Radiology - Vascular & Interventional Radiology in Southaven, MS

Active since August 29, 2019
55 PHYSICIANS LN, SOUTHAVEN, MS 38671(662) 655-2136(662) 996-2214 Get Directions Write a Review

NPPES record last updated: August 29, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Modern Vascular Of Southaven, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MODERN VASCULAR OF SOUTHAVEN, LLC (NPI 1174171441) is a healthcare organization registered as a vascular & interventional radiology in Southaven, Mississippi and active in the NPI registry since August 2019. The organization lists Yury Gampel, Manager, as its authorized official.

NPPES Registry Identity

NPI1174171441
Entity TypeOrganization
Primary Taxonomy2085R0204X
Legal Business NameMODERN VASCULAR OF SOUTHAVEN, LLC
Location Address55 PHYSICIANS LNSouthaven, MS 38671-9569
Mailing Address26500 Agoura Rd Ste 201Calabasas, CA 91302-3556 · (818) 880-8605 · Fax (818) 579-7916
Fax(662) 996-2214
Organization SubpartNo
Authorized OfficialYury GampelManager · (818) 880-8605
Enumeration DateAugust 29, 2019
NPI 1174171441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0204X
Definition

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

55 PHYSICIANS LN, Southaven, MS 38671

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Radiology (Vascular & Interventional Radiology)
55 PHYSICIANS LN
SOUTHAVEN, MS 38671
Neurological Surgery
55 PHYSICIANS LN, SUITE 1
SOUTHAVEN, MS 38671
Nurse Practitioner (Family)
55 PHYSICIANS LN
SOUTHAVEN, MS 38671
Nurse Practitioner (Acute Care)
55 PHYSICIANS LN
SOUTHAVEN, MS 38671

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Modern Vascular Of Southaven, LLC's NPI number?

The NPI number for Modern Vascular Of Southaven, LLC is 1174171441. It was assigned to this organization in the NPPES registry on August 29, 2019.

Where is Modern Vascular Of Southaven, LLC located?

Modern Vascular Of Southaven, LLC is located at 55 Physicians Ln, Southaven, MS 38671. The listed phone number is (662) 655-2136.

What is Modern Vascular Of Southaven, LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

What insurance does Modern Vascular Of Southaven, LLC accept?

Health plans from Molina Healthcare list Modern Vascular Of Southaven, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Modern Vascular Of Southaven, LLC was last updated on August 29, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.