South Georgia Medicine, P.C.
Internal Medicine, Gastroenterology in Tifton, GA. Organization (NPI-2).
NPI number1528126182
StatusActive
Last updated in NPPESJun 21, 2021
Details
- NPI
- 1528126182
- Entity type
- Organization (NPI-2)
- Legal business name
- South Georgia Medicine, P.C.
- Organization subpart
- No
- Enumeration date
- Dec 5, 2006
- Certification date
- Jun 21, 2021
- Last updated
- Jun 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RG0100X | Internal Medicine, Gastroenterology | 021582 | GA | Yes |
Practice location
1111 20th St ETifton, GA 31794-3689
Phone 229-382-9338 · Fax 229-382-4282
Mailing address
1111 20th St ETifton, GA 31794-3689
Phone 229-382-9338 · Fax 229-382-4282
Authorized official
Shirley Vickers Carrington
Billing Manager
2293829338
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