Organization
ALLERGY & DERMATOLOGY ASSOCIATES OF TIFTON PC
Active
Other names
Allergy, Asthma, & Sinsus Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY CLAYTON DORMINEY M.D. (OWNER)
(229) 382-3720
Entity
Organization
Contact information
Practice address
820 LOVE AVENUE, SUITE A, TIFTON, GA 31794
(229) 382-3720
(229) 382-3722
Mailing address
820 LOVE AVENUE, SUITE A, TIFTON, GA 31794
(229) 382-3720
(229) 382-3722
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
023352
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000239731A
—
GA
Enumeration date
10/29/2007
Last updated
07/26/2013
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