Organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Active
Other names
Meadows Medical Group ENT
Organization subpart
No
Provider details
NPI number
Authorized official
TONY M O'STEEN (CFO)
(912) 535-5560
Entity
Organization
Contact information
Practice address
1707 MEADOWS LN STE C, VIDALIA, GA 30474-7201
(912) 537-3384
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-3384
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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