Organization
SOUTHEASTERN CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH GRACE ELLIOTT-SMITH RN (PRACTICE MANAGER)
(912) 537-8988
Entity
Organization
Contact information
Practice address
1811 EDWINA DR, VIDALIA, GA 30474-8963
(912) 537-8988
(912) 608-8037
Mailing address
1811 EDWINA DR, VIDALIA, GA 30474-8963
(912) 537-8988
(912) 608-8037
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
53388
GA
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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