Organization
TIFT REGIONAL HEALTH SYSTEM, INC
Active
Other names
Southwell CHF and COPD Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DORMAN (PRESIDENT/CEO)
(229) 353-6104
Entity
Organization
Contact information
Practice address
1499 KENNEDY ROAD, SUITE A, TIFTON, GA 31794-4177
(229) 353-4243
(229) 353-3673
Mailing address
PO BOX 2650, TIFTON, GA 31793-2650
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Enumeration date
12/12/2019
Last updated
06/24/2022
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