Vidalia Surgical Associates, LLC

NPI #1124216312 in Vidalia, Georgia

Provider Information

NPI Number: 1124216312
Entity Type: Organization
Organization Name: Vidalia Surgical Associates, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHEAST REGIONAL CARE CORPORATION
Primary Specialty: Specialist
Enumeration Date: Oct 12, 2007
Last Updated: Jul 10, 2020

Practice Location

Address: 1811 EDWINA DR
City: Vidalia
State: Georgia
ZIP Code: 30474-8963
Phone: (912) 538-9977

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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