VIDALIA ENT ASSOCIATES, LLC (NPI# 1689851198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689851198 |
| Entity Type | Organization |
| Organization Name | VIDALIA ENT ASSOCIATES, LLC |
| Practice Address |
1707 Meadows Lane Suite C Vidalia GA 30474 |
| Mailing Address |
Po Box 407 Vidalia GA 30475-0407 |
| Practice Telephone | 9125373384 |
| Practice Fax Number | 9125373351 |
| Mailing Telephone | 9125373384 |
| Mailing Fax Number | 9125373351 |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2014-09-05 |
| Authorized Official Name | TONY M OSTEEN (CFO) |
| Authorized Official Telephone | 9125385314 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEAST REGIONAL PRIMARY CARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 060338 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1707 MEADOWS LANE SUITE C |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649338997 | John E Schoell | Internal Medicine | 1707 Meadows Lane, Suite E, Vidalia, GA 30474 | 2006-12-05 |
| 1316371792 | Vidalia Neurology Associates, LLC | Internal Medicine | 1707 Meadows Lane, Suite A, Vidalia, GA 30474-7200 | 2013-08-21 |
| 1437356359 | Vidalia Ob Gyn | Independent Medical Examiner | 1707 Meadows Lane, Vidalia, GA 30474 | 2007-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730655374 | Abby Virginia Adams | Speech-Language Pathologist | 101 Harris Insustrial Blvd, Vidalia, GA 30474 | 2018-10-22 |
| 1467930156 | Laurel Shiver Sapp | Nurse Practitioner | 1608 Meadows Ln, Vidalia, GA 30474 | 2018-08-03 |
| 1235658931 | Mary Frances Andrews | Nurse Practitioner | 1608 Meadows Lane Suite 1, Vidalia, GA 30474 | 2017-09-13 |
| 1154714574 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 104 Andrews Street, Suite 112, Vidalia, GA 30474 | 2015-03-10 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1801235312 | Paul Anderson Youth Home, Inc. | Substance Abuse Rehabilitation Facility | 1603 Mcintosh Street, Vidalia, GA 30474 | 2013-06-18 |
| 1043591076 | Kimberly Thigpen Evans | Nurse Practitioner | 621 East First Street, Unit B, Vidalia, GA 30474 | 2011-09-03 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1255586053 | Vidalia Medical Partners Inc. | Home Health | 801 Mcnatt Street, Vidalia, GA 30474 | 2008-11-20 |
| 1154596419 | Jill Nicole Lawrence | Speech-Language Pathologist | 1400 Ne Main St, Bethany Alf, Vidalia, GA 30474 | 2008-04-28 |
| Find all providers in zip 30474 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316105497 | The Head and Neck Clinic LLC | Otolaryngology | 107 Front St Ste 2141, Vidalia, LA 71373-2835 | 2008-05-27 |
| 1093887820 | Robert Eugene Johnson | Otolaryngology | 1707 Meadows Ln, Suite C, Vidalia, GA 30474-7200 | 2006-11-15 |
| 1184670036 | Ronald W Williams Jr. | Otolaryngology | 1707 Meadows Ln, Suite C, Vidalia, GA 30474-7200 | 2006-05-25 |
| 1801882634 | John A White | Otolaryngology | 107 Front St, Suite 240, Vidalia, LA 71373-2836 | 2005-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801402714 | Top Dog Solutions LLC | Otolaryngology | 4295 Interstate Dr Ste B, Macon, GA 31210-6815 | 2020-09-17 |
| 1164076600 | Oglethorpe Ear, Nose & Throat, LLC | Otolaryngology | 219 West Boggs Street, Lexington, GA 30648 | 2019-08-01 |
| 1154822971 | Coastal Ear, Nose & Throat | Otolaryngology | 200 Blue Moon Xing Ste 103, Pooler, GA 31322-9698 | 2018-02-27 |
| 1376928069 | Wiley A. Parker M.d PC | Otolaryngology | 5669 Peachtree Dunwoody Ste 295, Atlanta, GA 30342-1719 | 2015-07-23 |
| 1871970210 | North Atlanta Ear Nose & Throat PC | Otolaryngology | 4150 Deputy Bill Cantrell Memorial Dr., Suite 260, Cumming, GA 30040 | 2015-05-06 |
| 1235516741 | Alicia Bernstein | Otolaryngology | 3400c Old Milton Pkwy Ste 365, Alpharetta, GA 30005-4438 | 2015-05-04 |
| 1730576638 | Mark Arnold | Otolaryngology | 550 Peachtree St Ne Ste 1135550, Atlanta, GA 30308-2247 | 2015-04-20 |
| 1851789580 | William Lawrence Nicholson | Otolaryngology | 360 W 37th St, Sea Island, GA 31561-9748 | 2015-01-05 |
| 1528473881 | Nnenna Ezeilo | Otolaryngology | 619 S 8th St Ste 304, Griffin, GA 30224 | 2014-06-25 |
| 1922413343 | Colin Wyatt Fuller | Otolaryngology | 1120 Fifteenth St, Bp-4109, Augusta, GA 30912 | 2014-06-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.