| |
1909 Hwy. 82 West Suites 3 & 4 Tifton GA 31793 | |
(229) 445-3509 | |
(229) 445-3513 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1909 Hwy. 82 West, Tifton, Georgia |
Authorized Official Name and Position | Linda Young (EXECUTIVE SECRETARY) |
Authorized Official Contact | 2292738881 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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P.o. Box 5610 Cordele GA 31010 Ph: (229) 273-8881 | 1909 Hwy. 82 West Suites 3 & 4 Tifton GA 31793 Ph: (229) 445-3509 |
NPI Number | 1528556990 |
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Provider Enumeration Date | 05/01/2018 |
Last Update Date | 01/06/2020 |
Identifier | Type | State | Issuer |
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1528556990 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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 | |