Vidalia Neurology Associates, LLC

NPI #1316371792 in Vidalia, Georgia

Provider Information

NPI Number
1316371792
Entity Type
Organization
Organization Name
Vidalia Neurology Associates, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
SOUTHEAST PRIMARY CARE CORPORATION
Primary Specialty
Internal Medicine
Enumeration Date
Aug 21, 2013
Last Updated
Sep 5, 2014

Practice Location

Address
1707 MEADOWS LANE
Address 2
SUITE A
State
Georgia
ZIP Code
30474-7200
Phone
(912) 537-9779

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Internal Medicine

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