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Organization

DIM PHYSICIANS LLC

Active
Parent organization
SOUTHEAST REGIONAL. PRIMARY CARE CORP
Other names
DUBLIN INTERNAL MEDICINE
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTHEAST REGIONAL. PRIMARY CARE CORP
Authorized official
MR. TONY MARCUS O'STEEN CPA (CFO - SRPCC)
(912) 538-5314
Entity
Organization

Contact information

Practice address
104 FAIRVIEW PARK DR, DUBLIN, GA 31021-2500
(478) 272-1366
(478) 272-2240
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-4986
(912) 538-8166

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
11/07/2012
Last updated
04/15/2015
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