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Organization

TIFT REGIONAL HEALTH SYSTEM INC

Active
Other names
Southwell Nephrology
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER DORMAN (PRESIDENT/CEO)
(229) 353-6104
Entity
Organization

Contact information

Practice address
39 KENT RD STE 1, TIFTON, GA 31794-1697
(229) 391-4310
(229) 391-4243
Mailing address
PO BOX 2650, TIFTON, GA 31793-2650
(229) 353-3422

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Enumeration date
05/15/2020
Last updated
06/24/2022
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