| Tifton Family Medicine, Pc | |
|
902 18th St East Tifton GA 31794 | |
| (229) 382-6414 | |
| Not Available |
| Full Name | Tifton Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 902 18th St East, Tifton, Georgia |
| Authorized Official Name and Position | Marcus C Roberts (OWNER) |
| Authorized Official Contact | 2293826414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tifton Family Medicine, Pc 3025 Breckinridge Blvd Suite 120 Duluth GA 30096 Ph: (678) 226-0022 | Tifton Family Medicine, Pc 902 18th St East Tifton GA 31794 Ph: (229) 382-6414 |
| NPI Number | 1134225501 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 11/12/2007 |
| Medicare PECOS PAC ID | 2365430410 |
|---|---|
| Medicare Enrollment ID | O20040505001428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134225501 | NPI | - | NPPES |
| CL2838 | Other | GA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 035986 (Georgia) | Primary |
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