# TIFT REGIONAL HEALTH SYSTEM INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tift Regional Vascular
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184080079
- **Authorized official:** CHRISTOPHER DORMAN (PRESIDENT/CEO)
- **Authorized official phone:** (229) 353-6104

## Contact information

- **Practice address:** 1641 MADISON AVE, TIFTON, GA 31794-3757
- **Practice address phone:** (229) 353-2284
- **Practice address fax:** (229) 353-2285
- **Mailing address:** PO BOX 2650, TIFTON, GA 31793-2650
- **Mailing address phone:** (229) 353-3422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2016
- **Last updated:** 06/24/2022