Individual
DR. JIAN LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
(229) 391-4100
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
061794
GA
207RP1001X
Pulmonary Disease Physician
Primary
061794
GA
207RP1001X
Pulmonary Disease Physician
MD.201018
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061794
GA LICENSE
GA
05
—
643358747A
—
GA
05
—
G61794
—
SC
01
—
MD.201018
MD LICENSE
LA
Enumeration date
10/18/2006
Last updated
03/08/2021
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