Vidalia Urology Associates, LLC

NPI #1124284088 in Vidalia, Georgia

Provider Information

NPI Number: 1124284088
Entity Type: Organization
Organization Name: Vidalia Urology Associates, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Primary Specialty: Specialist
Enumeration Date: Jul 31, 2008
Last Updated: Jul 10, 2020

Practice Location

Address: 1707 MEADOWS LN STE F
City: Vidalia
State: Georgia
ZIP Code: 30474-7201
Phone: (912) 537-9481

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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