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General NPI Number Information
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NPI Number | 1760969018
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Entity Type | Individual
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Provider Name | CLAYTON ROSS TAPP
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Gender | Male
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2225 US HIGHWAY 41 N
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City | TIFTON
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State | GA
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Zip | 31794-2749
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Country | US
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Telephone | 229-391-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 12294 HIGHWAY 41
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City | SPARKS
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State | GA
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Zip | 31647-6520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP249392
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License Number State | GA
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