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4468 Union Rd Tifton GA 31794-8331 | |
(229) 353-6320 | |
(229) 353-6343 |
Full Name | |
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Speciality | Clinic/center |
Location | 4468 Union Rd, Tifton, Georgia |
Authorized Official Name and Position | Kristy Gladden (PROVIDER ENROLLMENT MANAGER) |
Authorized Official Contact | 2293533402 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4468 Union Rd Tifton GA 31794-8331 Ph: (229) 353-6320 | 4468 Union Rd Tifton GA 31794-8331 Ph: (229) 353-6320 |
NPI Number | 1003980996 |
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Provider Enumeration Date | 11/20/2006 |
Last Update Date | 11/21/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003980996 | NPI | - | NPPES |
137-180 | Other | GA | LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 137-180 (Georgia) | 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 | |