SOUTHEAST REGIONAL PRIMARY CARE CORPORATION (NPI# 1750883435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750883435 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST REGIONAL PRIMARY CARE CORPORATION |
| Other Organization Name | MEADOWS MEDICAL GROUP GASTROENTEROLOGY |
| Practice Address |
104 Fairview Park Dr Dublin GA 31021-2500 |
| Mailing Address |
Po Box 407 Vidalia GA 30475-0407 |
| Practice Telephone | 4782771255 |
| Mailing Telephone | 9125374986 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-08 |
| Authorized Official Name | TONY M O'STEEN (CFO) |
| Authorized Official Telephone | 9125355560 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Meadows Medical Group Gastroenterology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083117469 | Southeast Regional Primary Care Corporation | Otolaryngology | 1707 Meadows Ln Ste C, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1437652815 | Southeast Regional Primary Care Corporation | Podiatrist | 1707 Meadows Ln Ste H, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1225531197 | Southeast Regional Primary Care Corporation | Internal Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2018-03-16 |
| 1336642719 | Southeast Regional Primary Care Corporation | Internal Medicine | 101 Harris Industrial Blvd Ste A, Vidalia, GA 30474-8852 | 2018-03-13 |
| 1790288181 | Southeast Regional Primary Care Corporation | General Acute Care Hospital | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2018-03-13 |
| 1053814434 | Southeast Regional Primary Care Corporation | Urology | 303 Harris Industrial Blvd Ste 5, Vidalia, GA 30474-8854 | 2018-03-13 |
| 1134622517 | Southeast Regional Primary Care Corporation | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2018-03-13 |
| 1790288413 | Southeast Regional Primary Care Corporation | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2018-03-09 |
| 1619470333 | Southeast Regional Primary Care Corporation | Obstetrics & Gynecology | 101 Harris Industrial Blvd Ste C, Vidalia, GA 30474-8852 | 2018-03-09 |
| 1063914851 | Southeast Regional Primary Care Corporation | Internal Medicine | 621 E 1st St Ste B, Vidalia, GA 30474-4264 | 2018-03-07 |
| Street Address |
104 FAIRVIEW PARK DR |
| City | DUBLIN |
| State | GA |
| Zip Code | 31021-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750369153 | Sandeep C Dsouza | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021 | 2006-01-05 |
| 1982198073 | Hope Pediatrics, LLC | Pediatrics | 104 Fairview Park Dr, Dublin, GA 31021 | 2018-06-21 |
| 1124486089 | Crystal A Morgan | Nurse Practitioner | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2016-02-08 |
| 1629441613 | Gastroenterology Associates of Dublin LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2015-11-12 |
| 1992107411 | Dana Lewis Moore | Nurse Practitioner | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2014-09-16 |
| 1457605867 | Dim Physicians LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2012-11-07 |
| 1477870327 | Dublin Gastroenterology Assoc, LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2010-04-30 |
| 1255518890 | Leah Lord Helton | Pediatrics | 104 Fairview Park Dr, Dublin, GA 31021 | 2008-01-25 |
| 1811014939 | Arunasree Chukkapalli | Family Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2007-03-23 |
| 1740306315 | Dublin Internal Medicine Reference Lab | Clinical Medical Laboratory | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2007-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497213748 | Ronald E. Johnson | Peer Specialist | Carl Vinson Va Medical Center, 1826 Veterans Blvd., Dublin, GA 31021 | 2019-03-06 |
| 1902384811 | Nieka Jackson | Pharmacist | 75 Woodlawn Dr, Apt. C-1, Dublin, GA 31021 | 2018-08-02 |
| 1407341522 | Empower Psychiatry & Weight Loss, LLC | Nurse Practitioner | 112 Rowe St Ste B, Dublin, GA 31021 | 2018-06-30 |
| 1619462207 | Kara Emily Frost | Speech-Language Pathologist | 1406 Bellevue Rd, Dublin, GA 31021 | 2018-06-26 |
| 1376035410 | Owens Speech Services, LLC | Speech-Language Pathologist | 401 Barfield Court, Dublin, GA 31021 | 2018-06-05 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1376991000 | Eatonton Facility Development Company, LLC | Hospice, Inpatient | 155 Greensboro Rd, Eatonton, GA 31021 | 2016-06-03 |
| 1801261177 | Jones Community Health Center, LLC | Clinic/Center | 115 Shadow Pond, Dublin, GA 31021 | 2015-12-11 |
| 1508237561 | Cancer Center of Middle Georgia | Specialist | 26 Erin Office Park, Dublin, GA 31021 | 2015-10-15 |
| 1922477249 | Mickey Jackson | Non-emergency Medical Transport (VAN) | 610 John Robinson Tl., Dublin, GA 31021 | 2015-09-16 |
| Find all providers in zip 31021 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295706687 | Harish Grover | Internal Medicine | 118 Broad Street, Dublin, VA 24084 | 2006-02-01 |
| 1083692560 | Tirso A Castillo | Internal Medicine | 111 Fairview Park Dr, Dublin, GA 31021-2501 | 2006-01-05 |
| 1891788386 | Bruce L Hennessy | Internal Medicine | 6670 Perimeter Dr, Suite 200, Dublin, OH 43016-8056 | 2005-08-30 |
| 1629441613 | Gastroenterology Associates of Dublin LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2015-11-12 |
| 1871808790 | Mrudula V Kumar | Internal Medicine | 4050 Dublin Blvd, Department of Gastroenterology, Dublin, CA 94568-3112 | 2010-08-16 |
| 1477870327 | Dublin Gastroenterology Assoc, LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2010-04-30 |
| 1366564197 | Ryan Brelsford Gaible | Internal Medicine | 6670 Perimeter Dr, Suite 200, Dublin, OH 43016-8056 | 2007-04-04 |
| 1588716237 | Jon Paul Walker | Internal Medicine | 6670 Perimeter Dr Ste 200, Dublin, OH 43016-8065 | 2007-01-16 |
| 1629012794 | John J. Fromkes | Internal Medicine | 3900 Stoneridge Ln, Dublin, OH 43017-2009 | 2006-06-16 |
| 1316905763 | Bijoy Chandra Das | Internal Medicine | 1826 Veterans Blvd, Dublin, GA 31021-3620 | 2006-05-03 |
| Find all providers in DUBLIN | ||||
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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.