Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southeast Regional Primary Care Corporation

Organization Pediatrics Physician · NPI 1790288413

Southeast Regional Primary Care Corporation provides Pediatrics Physician services in Vidalia, Georgia. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

125 Church St
Vidalia, GA 30474-4770
Phone: (912) 538-8484
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1790288413
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tony O'Steen — Cfo · (912) 535-5560
Other names Meadows Medical Group Pediatrics
NPI enumeratedMarch 9, 2018
Last updated in NPPESMarch 9, 2018
Mailing addressPo Box 407, Vidalia, GA 30475-0407

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