Healthcare Provider Details

I. General information

NPI: 1992202568
Provider Name (Legal Business Name): TIFFANY NICOLE TURNER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 03/08/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PEDIATRICS OF DALTON 1409 CHATTANOOGA AVE EXT
DALTON GA
30720
US

IV. Provider business mailing address

1409 CHATTANOOGA AVE
DALTON GA
30720-2631
US

V. Phone/Fax

Practice location:
  • Phone: 706-278-5373
  • Fax:
Mailing address:
  • Phone: 706-278-5373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number93053
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: