Healthcare Provider Details

I. General information

NPI: 1407652530
Provider Name (Legal Business Name): CARE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 MADISON AVE
TIFTON GA
31794-3756
US

IV. Provider business mailing address

2808C N OAK ST
VALDOSTA GA
31602-1716
US

V. Phone/Fax

Practice location:
  • Phone: 229-387-8061
  • Fax:
Mailing address:
  • Phone: 229-241-8925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES RYAN MOORMAN
Title or Position: DC, OWNER
Credential: DC
Phone: 229-241-8925