Organization
TIFT REGIONAL HEALTH SYSTEM, INC
Active
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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