MEDICARE: THE ENDOSCOPY CENTER OF SOUTHEAST GEORGIA, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0800X	Endoscopy Clinic/Center	138082	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265439830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ENDOSCOPY CENTER OF SOUTHEAST GEORGIA, INC

Provider Business Mailing Address
First Line	:	200 MAPLE DR
Second Line	:
City	:	VIDALIA
State	:	GA
Zip	:	30474-8907
Country	:	US
Telephone Number	:	912-538-1003
Fax Number	:	912-537-9843

Provider Business Practice Location Address
First Line	:	200 MAPLE DR
Second Line	:
City	:	VIDALIA
State	:	GA
Zip	:	30474-8907
Country	:	US
Telephone Number	:	912-538-1003
Fax Number	:	912-537-9843

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. DIXIE LOUISE CALHOUN
Credential	:	BSN
Telephone Number	:	912-538-1003

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	01/29/2014

Similar Medicare Providers

1669465670 — DR. RONNIE R SMITH M. D.
Practice Location Address:

200 MAPLE DR
VIDALIA, GA
30474-8907

Practice Phone: 912-537-9851
Practice Fax: 912-537-9843

1639162175 — DR. DAREL C EDWARDS OD
Practice Location Address:

206 MAPLE DR
VIDALIA, GA
30474-8907

Practice Phone: 912-537-3004
Practice Fax: 912-537-7935

1982698346 — DR. JAMES H BARBER JR. M. D.
Practice Location Address:

200 MAPLE DR
VIDALIA, GA
30474-8907

Practice Phone: 912-537-9851
Practice Fax: 912-537-9843

1982698361 — DUSTIN J CARTER MPAS, PA-C
Practice Location Address:

200 MAPLE DR
VIDALIA, GA
30474-8907

Practice Phone: 912-537-9851
Practice Fax: 912-537-9843

1265426639 — ROBERT LEE ARNOLD MPAS, PA-C
Practice Location Address:

200 MAPLE DR
VIDALIA, GA
30474-8907

Practice Phone: 912-537-9851
Practice Fax: 912-537-9843

1235343807 — GEORGIA EYE INSTITUTE, INC.
Practice Location Address:

206 MAPLE DR
VIDALIA, GA
30474-8907

Practice Phone: 912-537-2020
Practice Fax: 912-350-4821

Directions to “THE ENDOSCOPY CENTER OF SOUTHEAST GEORGIA, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.