# SOUTHEAST REGIONAL PRIMARY CARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Meadows Medical Group Gastroenterology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750883435
- **Authorized official:** TONY M O'STEEN (CFO)
- **Authorized official phone:** (912) 535-5560

## Contact information

- **Practice address:** 104 FAIRVIEW PARK DR, DUBLIN, GA 31021-2500
- **Practice address phone:** (478) 277-1255
- **Mailing address:** PO BOX 407, VIDALIA, GA 30475-0407
- **Mailing address phone:** (912) 537-4986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2018
- **Last updated:** 03/08/2018