Basic Information
| Provider Information | |||||||||
| NPI: | 1689984684 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VPA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1239 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480991239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007597291 | ||||||||
| FaxNumber: | 2482690631 | ||||||||
| Practice Location | |||||||||
| Address1: | 355 E CAMPUS VIEW BLVD | ||||||||
| Address2: | STE 180 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432355680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148401688 | ||||||||
| FaxNumber: | 2482690631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2010 | ||||||||
| LastUpdateDate: | 03/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | SASSER | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2488246000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | H04170 | 01 | OH | MEDICARE | OTHER | 0075478 | 05 | OH | MEDICAID |