Organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Active
Other names
Meadows Medical Group Urology
Organization subpart
No
Provider details
NPI number
Authorized official
TONY M O'STEEN (CFO)
(912) 535-5560
Entity
Organization
Contact information
Practice address
303 HARRIS INDUSTRIAL BLVD STE 5, VIDALIA, GA 30474-8854
(912) 537-9481
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-9481
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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