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72 Kent Rd Ste 4 Tifton GA 31794-1695 | |
(229) 386-5101 | |
(229) 386-2277 |
Full Name | |
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Speciality | Family Medicine |
Location | 72 Kent Rd Ste 4, Tifton, Georgia |
Authorized Official Name and Position | Nandlal Chainani (CEO) |
Authorized Official Contact | 2293865101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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72 Kent Rd Ste 4 Tifton GA 31794-1695 Ph: (229) 386-5101 | 72 Kent Rd Ste 4 Tifton GA 31794-1695 Ph: (229) 386-5101 |
NPI Number | 1760660203 |
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Provider Enumeration Date | 02/07/2008 |
Last Update Date | 08/30/2023 |
Medicare PECOS PAC ID | 3971799867 |
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Medicare Enrollment ID | O20101117001320 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760660203 | NPI | - | NPPES |
202G701254 | Other | GA | MEDICARE PTAN |
7959569408A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 63840 (Georgia) | Primary |
208000000X | Pediatrics | 44893 (Georgia) | Secondary |
Provider Name | Navdeepa Chainani |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1871804641 PECOS PAC ID: 8820284714 Enrollment ID: I20101117001378 |
Provider Name | Nandlal Chainani |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1952482135 PECOS PAC ID: 4880880772 Enrollment ID: I20101117001477 |
Provider Name | Rebekah Marie Tucker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265196869 PECOS PAC ID: 6002196854 Enrollment ID: I20220407000591 |
Tifton Family Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 902 18th St East, Tifton, GA 31794 Phone: 229-382-6414 | |
Gowdy Enterprises Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2406 Tift Ave N, Suite 202, Tifton, GA 31794 Phone: 770-355-2064 Fax: 229-238-3940 | |
Allhealth Choice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 242 2nd St E Ste B, Tifton, GA 31794 Phone: 404-996-0086 | |