Organization
TIFTON RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND C EVANS MD (PRESIDENT)
(912) 287-1515
Entity
Organization
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(912) 287-1515
(912) 287-1394
Mailing address
901 18TH ST E, TIFTON, GA 31794-3648
(912) 287-1515
(912) 287-1394
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30020597B
—
GA
Enumeration date
08/23/2005
Last updated
07/21/2022
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