Vidalia Ent Associates, LLC

NPI #1689851198 in Vidalia, Georgia

Provider Information

NPI Number: 1689851198
Entity Type: Organization
Organization Name: Vidalia Ent Associates, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Primary Specialty: Otolaryngology
Enumeration Date: Jan 28, 2008
Last Updated: Sep 5, 2014

Practice Location

Address: 1707 MEADOWS LANE
Address 2: SUITE C
City: Vidalia
State: Georgia
ZIP Code: 30474
Phone: (912) 537-3384

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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Individual Providers

Provider Name	Specialty	City
Robert Eugene Johnson, MD	Otolaryngology	Vidalia	AI Deep Dive
MR. Ronald W Williams JR., MD	Otolaryngology	Vidalia	AI Deep Dive
DR. Michael Frances Pratt, M.D.	Otolaryngology	Woodstock	AI Deep Dive

Organizations

Provider Name	Specialty	City
Southeast Regional Primary Care Corporation	Otolaryngology	Vidalia	AI Deep Dive
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