Organization
SOUTH GEORGIA DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTYN ELIZABETH RENFROE (PRACTICE MANAGER)
(229) 386-9333
Entity
Organization
Contact information
Practice address
802 18TH ST E, TIFTON, GA 31794-3661
(229) 386-9333
(229) 386-1666
Mailing address
802 18TH ST E, TIFTON, GA 31794-3661
(229) 386-9333
(229) 386-1666
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
044059
GA
Other
Enumeration date
12/14/2006
Last updated
08/22/2020
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