Organization
TIFT REGIONAL HEALTH SYSTEM, INC
Active
Other names
Southwell Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DORMAN (PRESIDENT/CEO)
(229) 353-6104
Entity
Organization
Contact information
Practice address
2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
(229) 391-4100
(229) 391-4508
Mailing address
PO BOX 2650, TIFTON, GA 31793-2650
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2020
Last updated
09/03/2025
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