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2735 Central Ave S Tifton GA 31794-5645 | |
(229) 388-5690 | |
(229) 388-5685 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2735 Central Ave S, Tifton, Georgia |
Authorized Official Name and Position | Christopher Dorman (PRESIDENT/CEO) |
Authorized Official Contact | 2293536104 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2650 Tifton GA 31793-2650 Ph: (229) 353-3422 | 2735 Central Ave S Tifton GA 31794-5645 Ph: (229) 388-5690 |
NPI Number | 1649800111 |
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Provider Enumeration Date | 01/23/2020 |
Last Update Date | 06/24/2022 |
Medicare PECOS PAC ID | 2062745169 |
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Medicare Enrollment ID | O20200717001168 |
Identifier | Type | State | Issuer |
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1649800111 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (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 | |