Organization
SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL
Active
Parent organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATIO
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST REGIONAL PRIMARY CARE CORPORATIO
Authorized official
TONY M OSTEEN (CFO)
(912) 538-5314
Entity
Organization
Contact information
Practice address
1811 MANNING DR, VIDALIA, GA 30474-8921
(912) 535-2554
(912) 535-2558
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-4986
(912) 535-2558
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
08/15/2012
Last updated
08/25/2014
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