Organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Active
Other names
Meadows Medical Group Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
TONY M O'STEEN (CFO)
(912) 535-5560
Entity
Organization
Contact information
Practice address
104 FAIRVIEW PARK DR, DUBLIN, GA 31021-2500
(478) 277-1255
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-4986
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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