# TIFT REGIONAL HEALTH SYSTEM INC

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

## Provider details

- **NPI number:** 1083522106
- **Authorized official:** CHRISTOPHER DORMAN (PRESIDENT/CEO)
- **Authorized official phone:** (229) 353-6121

## Contact information

- **Practice address:** 501 N IRWIN AVE STE B, OCILLA, GA 31774-5007
- **Practice address phone:** (229) 353-2250
- **Mailing address:** PO BOX 2650, TIFTON, GA 31793-2650
- **Mailing address phone:** (229) 353-3422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/31/2026
- **Last updated:** 08/31/2026