# SOUTHEAST REGIONAL PRIMARY CARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Meadows Medical Group Lung and Sleep
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225531197
- **Authorized official:** TONY M O'STEEN (CFO)
- **Authorized official phone:** (912) 535-5560

## Contact information

- **Practice address:** 1811 EDWINA DR, VIDALIA, GA 30474-8963
- **Practice address phone:** (912) 538-8105
- **Mailing address:** PO BOX 407, VIDALIA, GA 30475-0407
- **Mailing address phone:** (912) 538-8105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | Yes |
| 207RP1001X | Pulmonary Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2018
- **Last updated:** 03/16/2018