Vidalia Urology Associates, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

VIDALIA UROLOGY ASSOCIATES, LLC

Practice address

1707 Meadows LN Ste F
Vidalia, GA 30474-7201

Phone

(912) 537-9481

NPI assigned

Jul 31, 2008

Organization subpart

Yes

Parent organization

SOUTHEAST REGIONAL PRIMARY CARE CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tony M Osteen

Title

Cfo

Phone

(912) 538-5314

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Southeast Regional Primary Care Corporation

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1124284088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-537-9481",
            "fax_number": "912-537-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 MEADOWS LN STE F",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304747201",
            "telephone_number": "912-537-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDALIA UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST REGIONAL PRIMARY CARE CORPORATION",
        "enumeration_date": "2008-07-31",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "OSTEEN",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-538-5314"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "511G700994",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vidalia Pharmacy Inc
• Vidalia Pulmonology Center, LLC
• Vidalia Radiology Associates
• Vidalia Regional Cancer Center
• Vidalia Surgical Associates, LLC
• Vidalia Women'S Center, LLC
• VPC, Inc.
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Lyndsay M Waldhour, RD, LD

• Specialist in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.