Tifton Radiology PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

TIFTON RADIOLOGY PC

Practice address

901 18TH St E
Tifton, GA 31794-3648

Phone

(912) 287-1515

Fax

(912) 287-1394

NPI assigned

Aug 23, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raymond C Evans, MD

Title

President

Phone

(912) 287-1515

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780677922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "912-287-1515",
            "fax_number": "912-287-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "912-287-1515",
            "fax_number": "912-287-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFTON RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-287-1515",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30020597B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tifton Operating Company LLC (Tifton Health and Rehabilitation Center)
• Tifton Ophthalmology Associates. PC
• Tifton Orthopaedic Clinic, PC
• Tifton Pain Management, P.C.
• Tifton Pathological Services
• Tifton Woman's Center, P.C.
• Tristen Breann Tiller, BCBA
• Gerlana S Todd
• Cheryl Gatewood Tolliver, M.D.
• Amanda Tomberlin

• Diagnostic Radiology Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.