Individual
DR. SWATHI SREE NUTAKKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(404) 756-1368
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
84255
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2016
Last updated
03/08/2021
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