Organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Active
Other names
Meadows Medical Group General and Vascular Surgery
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, VIDALIA, GA 30474-8853
(912) 538-9977
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 535-5560
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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