Organization
TIFTON FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS C ROBERTS M.D. (OWNER)
(229) 382-6414
Entity
Organization
Contact information
Practice address
902 18TH ST EAST, TIFTON, GA 31794
(229) 382-6414
Mailing address
3025 BRECKINRIDGE BLVD, SUITE 120, DULUTH, GA 30096
(678) 226-0022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
035986
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL2838
RAILROAD MEDICARE
GA
Enumeration date
09/15/2006
Last updated
11/12/2007
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