Southeast Regional Primary Care Corporation

NPI #1225531197 in Vidalia, Georgia

Provider Information

NPI Number
1225531197
Entity Type
Organization
Organization Name
Southeast Regional Primary Care Corporation
Primary Specialty
Internal Medicine - Pulmonary Disease
Enumeration Date
Mar 16, 2018
Last Updated
Mar 16, 2018

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) 535-5560

Specialties & Taxonomy Codes

Specialty
Internal Medicine - Pulmonary DiseasePulmonary Disease

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