Southeast Regional Primary Care Corporation

NPI #1073015095 in Vidalia, Georgia

Provider Information

NPI Number
1073015095
Entity Type
Organization
Organization Name
Southeast Regional Primary Care Corporation
Primary Specialty
Surgery
Enumeration Date
Mar 6, 2018
Last Updated
Mar 6, 2018

Practice Location

Address
303 HARRIS INDUSTRIAL BLVD
State
Georgia
ZIP Code
30474-8853
Phone
(912) 538-9977

Authorized Official

Name
TONY M O'STEEN
Title
CFO
Phone
(912) 535-5560

Specialties & Taxonomy Codes

Specialty
Specialist
Surgery

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