EUGENE VITVITSKY MD (NPI# 1265657969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265657969 |
| Entity Type | Organization |
| Organization Name | EUGENE VITVITSKY MD |
| Other Organization Name | HAVASU VEIN CENTER |
| Practice Address |
2046 Burke Lane Lake Havasu City AZ 86406 |
| Mailing Address |
1845 Mccolloch Blvd Suite A-2 Lake Havasu City AZ 86403 |
| Practice Telephone | 9288554411 |
| Practice Fax Number | 9288554418 |
| Mailing Telephone | 9288554411 |
| Mailing Fax Number | 9288554418 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EUGENE VITVITSKY (CO-OWNER) |
| Authorized Official Telephone | 9288554411 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
35142 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BLUE CROSS OF ARIZONA | AZ0440881 | 01 |
| Other Name | Type Code |
|---|---|
| Havasu Vein Center | Doing Business As Name - Organization |
| Street Address |
2046 BURKE LANE |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924070 | James Richard Fisher | Durable Medical Equipment & Medical Supplies | 2540 Viejo Dr, Lake Havasu City, AZ 86406 | 2008-02-27 |
| 1659497105 | Assisted Living Concepts Inc | Assisted Living Facility | 3076 Shoshone Drive, Lake Havasu, AZ 86406 | 2007-03-22 |
| 1164546750 | Charles Reese Mead | Dentist | 101 Riveria Dr, Lake Havasu, AZ 86406 | 2007-03-19 |
| 1427172550 | Jesdeen Lynn Nunez | Registered Nurse | 12033 Agency Road, Parker, AZ 86406 | 2007-03-16 |
| 1285797993 | Karen Ann Powell | Podiatrist | Oro Grande Elementary 1250 Pawnee Drive, Lake Havasu City, AZ 86406 | 2006-12-18 |
| 1215978606 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2800 Sweetwater Ave, Lake Havasu City, AZ 86406 | 2006-06-09 |
| 1467519512 | Catherine Evelyn Sondrol | Occupational Therapist | 3588 Tarpon Dr, Lake Havasu City, AZ 86406-4223 | 2007-01-01 |
| 1346477593 | Steven Bertovich | Registered Nurse | 3499 Tarpon Dr, Lake Havasu City, AZ 86406-4246 | 2009-06-15 |
| 1093975310 | Serenity Assisted Living | Assisted Living Facility | 3677 Blue Colt Dr, Lake Havasu City, AZ 86406-4273 | 2008-06-10 |
| 1255865648 | Cassidy Flenner | Specialist/Technologist | 3887 Bluegrass Dr, Lake Havasu City, AZ 86406-4362 | 2017-04-12 |
| Find all providers in zip 86406 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427283092 | Western Arizona Cardiovascular Surgery Pllc | Surgery | 1851 Mesquite Ave, Suite 202, Lake Havasu City, AZ 86403-5677 | 2009-05-26 |
| 1699765834 | Rio Vista Surgical Associates, P.C. | Surgery | 90 Riviera Dr, Lake Havasu City, AZ 86403-5716 | 2005-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127858 | Flagstaff Pain and Treatment Center LLC | Surgery | 823 N San Francisco St, Flagstaff, AZ 86001-3294 | 2020-08-31 |
| 1013531268 | Honorhealth Ambulatory | Surgery | 6220 W Bell Rd Ste 120, Glendale, AZ 85308-3896 | 2020-06-03 |
| 1649894890 | Honorhealth Ambulatory | Surgery | 9250 N 3rd St Ste 2000, Phoenix, AZ 85020-2403 | 2020-06-03 |
| 1275157414 | Honorhealth Ambulatory | Surgery | 18404 N Tatum Blvd Ste 201, Phoenix, AZ 85032-1508 | 2020-06-03 |
| 1568025617 | Caronae Howell | Surgery | University of Arizona/vascular Surgery Section, 1501 N. Campbell Ave., Room 4402, Tucson, AZ 85724 | 2019-04-15 |
| 1790144889 | Scottsdale Healthcare Corporation | Surgery | 7301 E Osborn Rd., Suite 100, Scottsdale, AZ 85251 | 2016-02-17 |
| 1588061535 | Eugene Melvin Zweiback Md | Surgery | 7619 E Nogales Road, Scottsdale, AZ 85258 | 2014-11-19 |
| 1821434184 | Rio Vista Surgical Associates P.C. | Surgery | 1200 Mohave Dr, Parker, AZ 85344 | 2013-05-14 |
| 1275876518 | Sara Catherine Mckeever | Surgery | 6565 E Carondelet Dr Ste 235, Tucson, AZ 85710-3533 | 2013-04-05 |
| 1689928061 | Michael Arthur Davis | Surgery | 2744 Silver Creek Rd, Bullhead City, AZ 86442-7913 | 2012-11-06 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86406 |
Please comment or provide details below to improve the information on EUGENE VITVITSKY MD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.