Vidalia Pulmonology Center, LLC

NPI #1194985093 in Vidalia, Georgia

Provider Information

NPI Number
1194985093
Entity Type
Organization
Organization Name
Vidalia Pulmonology Center, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Primary Specialty
Internal Medicine - Pulmonary Disease
Enumeration Date
Jun 13, 2008
Last Updated
May 29, 2014

Practice Location

Address
1811 EDWINA DR
State
Georgia
ZIP Code
30474-8963
Phone
(912) 538-8105

Authorized Official

Name
TONY M O'STEEN
Title
CFO
Phone
(912) 538-5314

Specialties & Taxonomy Codes

Specialty
Internal Medicine - Critical Care MedicineCritical Care Medicine
Internal Medicine - Sleep MedicineSleep Medicine
Internal Medicine - Pulmonary DiseasePulmonary Disease

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