Organization
VIDALIA IMMEDIATE & PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ANN BECKUM (PRACTICE MANAGER/OFFICE MANAGER)
(912) 293-2869
Entity
Organization
Contact information
Practice address
122 ALICE COLEMAN DRIVE, VIDALIA, GA 30474
(912) 805-2273
Mailing address
PO BOX 2324, VIDALIA, GA 30475-2324
(912) 805-2273
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
11/16/2021
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