SOUTHEAST REGIONAL PRIMARY CARE CORPORATION NPI 1467568907

NPI Information

NPI: 1467568907
Provider Name: SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
ONE MEADOWS PARKWAY
VIDALIA, GA
ZIP 30474
Phone: (912) 535-3011
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SOUTHEAST REGIONAL PRIMARY CARE CORPORATION is a multi-specialty clinic center in Vidalia, GA. SOUTHEAST REGIONAL PRIMARY CARE CORPORATION NPI is 1467568907. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

ONE MEADOWS PARKWAY
VIDALIA, GA
ZIP 30474-921
Phone: (912) 535-3011
Fax: (912) 537-5366

The provider's authorized official is Tony M Osteen .
The authorized official title is Cfo and has the following contact phone number (912) 535-8691.

The enumeration date for this NPI number is 8/21/2006 and was last updated on 3/13/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	207Q00000X	Family Medicine		GEORGIA	No
2	261QM1300X	Clinic/Center	Multi-Specialty		Yes
3	261QP2300X	Clinic/Center	Primary Care		No
4	261QR0200X	Clinic/Center	Radiology		No
5	261QS1200X	Clinic/Center	Sleep Disorder Diagnostic		No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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