# TIFT REGIONAL HEALTH SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southwell Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861022329
- **Authorized official:** CHRISTOPHER DORMAN (PRESIDENT/CEO)
- **Authorized official phone:** (229) 353-6104

## Contact information

- **Practice address:** 2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
- **Practice address phone:** (229) 391-4100
- **Practice address fax:** (229) 391-4508
- **Mailing address:** PO BOX 2650, TIFTON, GA 31793-2650
- **Mailing address phone:** (229) 353-3422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/23/2020
- **Last updated:** 09/03/2025