Healthcare Provider Details

I. General information

NPI: 1619066826
Provider Name (Legal Business Name): CHERYL TAYLOR CLIFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEADOWS PKWY
VIDALIA GA
30474-8759
US

IV. Provider business mailing address

1 MEADOWS PKWY
VIDALIA GA
30474-8759
US

V. Phone/Fax

Practice location:
  • Phone: 912-535-5555
  • Fax: 912-535-5068
Mailing address:
  • Phone: 912-535-5555
  • Fax: 912-535-5068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number040034
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: