# TIFT COUNTY HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fitzgerald Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013315605
- **Authorized official:** LINDA A WILSON (VP PHYSICIAN SERVICES)
- **Authorized official phone:** (229) 353-3403

## Contact information

- **Practice address:** 246 BEN HILL DRIVE, FITZGERALD, GA 31750
- **Practice address phone:** (229) 423-2400
- **Practice address fax:** (229) 423-2472
- **Mailing address:** 907 18TH ST E, SUITE 150, TIFTON, GA 31794-3643
- **Mailing address phone:** (229) 423-2400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 030071 | GA | Yes |

## Other

- **Enumeration date:** 12/12/2014
- **Last updated:** 12/12/2014