Organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Active
Other names
Meadows Medical Group Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
TONY M O'STEEN (CFO)
(912) 535-5560
Entity
Organization
Contact information
Practice address
621 E 1ST ST STE B, VIDALIA, GA 30474-4264
(912) 535-5120
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/07/2018
Last updated
12/21/2018
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