Southeast Regional Primary Care Corporation

NPI #1134622517 in Vidalia, Georgia

Provider Information

NPI Number: 1134622517
Entity Type: Organization
Organization Name: Southeast Regional Primary Care Corporation
Primary Specialty: Anesthesiology
Enumeration Date: Mar 13, 2018
Last Updated: Mar 13, 2018

Practice Location

Address: 1 MEADOWS PKWY
City: Vidalia
State: Georgia
ZIP Code: 30474-8759
Phone: (912) 537-4986

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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