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Individual

MR. JON R TEEGARDIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
331 SOMERS LN, TIFTON, GA 31794-1894
(229) 539-2210
Mailing address
331 SOMERS LN, TIFTON, GA 31794-1894

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
RN227482
GA
261QP2300X
Primary Care Clinic/Center
363LF0000X
Family Nurse Practitioner
Primary
RN227482
GA

Other

Enumeration date
09/11/2018
Last updated
03/07/2024
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