Organization · NPI-2

The Orthopedic Spine Center

Clinic/Center · Tifton, GA

NPI number1558680462
StatusActive
Last updated in NPPESMay 21, 2010

Details

NPI
1558680462
Entity type
Organization (NPI-2)
Legal business name
The Orthopedic Spine Center
Organization subpart
No
Enumeration date
May 18, 2010
Last updated
May 21, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center048965GAYes

Practice location

1622 Madison Ave
Tifton, GA 31794-3756

Phone 229-388-5625

Mailing address

1622 Madison Ave
Tifton, GA 31794-3756

Phone 229-388-5625

Authorized official

Hewatt M Sims
Owner/Managing Member
2293885625

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center providers in Tifton, GA