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General NPI Number Information
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NPI Number | 1669324901
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Entity Type | Organization
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Legal Business Name | SPRINGTIDE HEALTH PARTNERS, LLC
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 124 GORDON ST
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City | WASHINGTON
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State | GA
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Zip | 30673-1602
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Country | US
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Telephone | 706-678-3793
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | WASHINGTON
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State | GA
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Zip | 30673-0187
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Country | US
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Telephone | 706-678-3793
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARY AUSTIN SANDERS HEFTY
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Credential | MD
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Telephone | 864-293-5402
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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 |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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