Southeast Regional Primary Care Corporation
Organization Active NPI Multi-Specialty Clinic/Center · Vidalia, GA
NPI 1467568907 · NPPES record last updated Mar 13, 2019
Key facts
- NPI
- 1467568907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
- Practice address
- One Meadows Parkway
Vidalia, GA 30474-8921 - Phone
- (912) 535-3011
- Fax
- (912) 537-5366
- NPI assigned
- Aug 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Tony M Osteen
- Title
- Cfo
- Phone
- (912) 535-8691
Practitioners 37
-
Ashley Hill Adams, FNP
-
Jeanie L Allen, NURSE PRACTIONER
-
Taylor Alexandria Andre, MSN, APRN, FNP-C
-
Robert Andrew Bell, FNP
-
Kristin Brantley, NP
-
Albert A Burton, M.D.
-
Allahna Allybia Coggins, M.D.
-
Matthew Demore III, D.P.M.
-
Sandra Jones Dickerson, M.D.
-
Kendrix Jermaine Evans, M.D.
-
Henry Leon Ferland III, D.O.
-
Paul Joseph Giles, M.D.
-
Gilbert J. Gonzalez, M.D.
-
Matthew B Grundfast, D.O.
-
Christy L Hartley, CNM/ARNP
-
Ciara Haugabrook, NP
-
Mark Hoerman, MD
-
Kurt Patrick Hofmann, M.D.
-
Pate Howell, APRN
-
Herbert Chapman Jones, M.D.
-
Archie Thomas Kirkley, PA-C
National Provider Directory
Locations
1525 Fair Rd
Ste 105
Statesboro, GA 30458
Phone (888) 207-0008
1525 Fair Rd
Ste 105A
Statesboro, GA 30458
Phone (276) 591-8383
621 E 1st St
Ste B
Vidalia, GA 30474
Phone (912) 535-5555
Interoperability endpoints
- anju.sinha@srpcc.gadirect.net
- stanley.morgan@srpcc.gadirect.net
- pate.chester@srpcc.gadirect.net
- archie.kirkley@srpcc.gadirect.net
- robert.scanlon@srpcc.gadirect.net
- henry.ferland@srpcc.gadirect.net
- karen.mccoll@srpcc.gadirect.net
- kendrix.evans@srpcc.gadirect.net
- kristin.brantley@srpcc.gadirect.net
- ciara.haugabrook@srpcc.gadirect.net
- daniel.hartley@srpcc.gadirect.net
- christina.tidwell@srpcc.gadirect.net
- samuel.featherston@srpcc.gadirect.net
- kurt.hofmann@srpcc.gadirect.net
- taylor.andre@srpcc.gadirect.net
- matthew.grundfast@srpcc.gadirect.net
- sandra.dickerson@srpcc.gadirect.net
- courtney.ragan@srpcc.gadirect.net
- chelsea.tehan@srpcc.gadirect.net
- katherine.collins@srpcc.gadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | GA | ||
| Multi-Specialty Clinic/Center | 261QM1300X | Yes | ||
| Primary Care Clinic/Center | 261QP2300X | |||
| Radiology Clinic/Center | 261QR0200X | |||
| Sleep Disorder Diagnostic Clinic/Center | 261QS1200X |
Addresses
Primary practice location
One Meadows Parkway
Vidalia, GA 30474-8921
Mailing address
PO Box 407
Vidalia, GA 30475-0407
Phone (912) 535-3011
Other practice location 1
621 E 1st St Ste B
Vidalia, GA 30474-4264
Phone (912) 535-5555
Other practice location 2
1707 Meadows Ln Ste B
Vidalia, GA 30474-7201
Phone (912) 535-7100
Other practice location 3
1525 Fair Rd Ste 105A
Statesboro, GA 30458-6118
Phone (800) 207-0008
Other practice location 4
303 Harris Industrial Blvd Ste 5
Vidalia, GA 30474-8854
Phone (912) 535-7000
Other providers in Vidalia, GA
- Southeast Regional Primary Care Corporation
- Southeast Regional Primary Care Corporation
- Southeast Regional Primary Care Corporation
- Southeast Regional Primary Care Corporation
- Southeast Regional Primary Care Corporation
- Southeast Regional Primary Care Corporation
- Southeast Regional Primary Care Corporation
- Southeast Regional Primary Care Corporation
- Southeastern Cardiology
- Southeastern Cardiovascular Img, Inc.
All providers in Vidalia, GA · Multi-Specialty Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.