| NPI | 1003176546 |
|---|---|
| Doing Business As | VIDALIA INTERNAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MISTY D POOLE Owner 912-537-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2015-10-09 |