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General NPI Number Information
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NPI Number | 1366765166
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Entity Type | Organization
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Legal Business Name | TIFT REGIONAL HEALTH SYSTEM INC
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Dates
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Enumeration Date | 03/08/2010
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 39 KENT RD STE 5
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City | TIFTON
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State | GA
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Zip | 31794-1697
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Country | US
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Telephone | 229-353-7337
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Fax | 229-391-4051
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Provider Business Mailing Address
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Address Line | PO BOX 2650
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City | TIFTON
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State | GA
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Zip | 31793-2650
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Country | US
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Telephone | 229-353-3422
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | CHRISTOPHER DORMAN
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Credential |
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Telephone | 229-353-6104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | GA
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