Organization · Type 2 NPI

Tift Regional Health System Inc

School Nurse Practitioner · Tifton, GA

NPI number 1508428442 Active

Practice location

1464 Carpenter Road S
Tifton, GA 31793

Call (229) 353-2227 Map

Fax (229) 388-9515

Mailing address

PO Box 2650
Tifton, GA 31793-2650

Other practice locations

700 8th St W, Tifton, GA 31794-3803 · (229) 353-3767

Specialties and licenses

Taxonomy	Code	License
School Nurse Practitioner Primary	363LS0200X	None listed

School Nurse Practitioner: Definition to come...

NPI record

NPI: 1508428442
Entity type: Organization (Type 2)
Issued: Jul 1, 2019
Last updated: Jun 24, 2022
Status: Active

Other names

<unavail>
Southwell School Clinic · doing business as
Southwell School Clinic · doing business as

Authorized official

Christopher Dorman
President/ceo
(229) 353-6104

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1508428442

Tift Regional Health System Inc's National Provider Identifier is 1508428442, issued on Jul 1, 2019. The primary taxonomy on file is School Nurse Practitioner (363LS0200X), and the practice location is in Tifton, GA. The record was last updated on Jun 24, 2022.