| NPI | 1710043237 |
|---|---|
| Doing Business As | VIDALIA PEDIATRIC CLINIC |
| Entity Type | Organization |
| Authorized Contact | CARSON HUGH SMITH C.O.O./Co Owner 912-537-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2024-10-18 |