NPIMap

Tift Regional Health System Inc

Organization Active NPI Medical Oncology Physician · Tifton, GA

NPI 1306158480 · NPPES record last updated Jun 24, 2022

Key facts

NPI
1306158480
Entity type
Organization (NPI type 2)
Primary specialty
Medical Oncology Physician 207RX0202X
Legal business name
TIFT REGIONAL HEALTH SYSTEM INC
Practice address
1623 Madison Ave
Tifton, GA 31794-3757
Phone
(229) 353-7720
NPI assigned
Jul 6, 2010
Organization subpart
No

Authorized official

Name
Christopher Dorman
Title
President/Ceo
Phone
(229) 353-6104

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200217002409 GA Part B Supplier - Clinic/Group Practice 2062745169 Receives reassigned benefits from 389 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tifton, GA; Adel, GA

National Provider Directory

Tax ID family
Tift Regional Health System Inc (19 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RX0202X Yes

Addresses

Primary practice location

1623 Madison Ave
Tifton, GA 31794-3757

Mailing address

PO Box 2650
Tifton, GA 31793-2650
Phone (229) 353-3422

Other names

  • TRMC Oncology Professionals Doing business as

Other providers in Tifton, GA

All providers in Tifton, GA · Medical Oncology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.