Tifton Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TIFTON CLINIC LLC

Practice address

1623 Old Ocilla Rd
Tifton, GA 31794-4173

Phone

(229) 891-9131

NPI assigned

Nov 19, 2014

Last updated

Nov 19, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

COLQUITT REGIONAL MEDICAL INCAs reported in NPPES

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

Authorized official

Name

Wendell L Sims

Title

Coo

Phone

(229) 890-3531

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1841696879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2876",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762876",
            "telephone_number": "229-891-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944173",
            "telephone_number": "229-891-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFTON CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLQUITT REGIONAL MEDICAL INC",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "229-890-3531"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiftarea Surgical Partners, LLC
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• Tifton Addiction Associates, LLC. D/B/a TLC Clinic
• Tifton Anesthesia Associates, P.C.
• Tifton Cardiovascular,LLC
• Tifton Endoscopy Center, Inc.
• Tifton Family Medicine, PC
• Tifton Operating Company LLC (Tifton Health and Rehabilitation Center)
• Tifton Ophthalmology Associates. PC
• Tifton Orthopaedic Clinic, PC

• Family Medicine Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.