Southeast Regional Kidney and Hypertension Specialists, Ll

NPI #1104174655 in Vidalia, Georgia

Provider Information

NPI Number
1104174655
Entity Type
Organization
Organization Name
Southeast Regional Kidney and Hypertension Specialists, Ll
Subpart
Yes (part of a larger organization)
Parent Organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATIO
Primary Specialty
Internal Medicine - Nephrology
Enumeration Date
Aug 15, 2012
Last Updated
Aug 25, 2014

Practice Location

Address
1811 MANNING DR
State
Georgia
ZIP Code
30474-8921
Phone
(912) 535-2554

Authorized Official

Name
TONY M OSTEEN
Title
CFO
Phone
(912) 538-5314

Specialties & Taxonomy Codes

Specialty
Internal Medicine - NephrologyNephrology

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