Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Mar 30, 2021
License(s)
101480 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2225 US HIGHWAY 41 N | Tifton, GA 31794-2749 | 229-391-4100 |
| MAILING | PO BOX 2650 | Tifton, GA 31793-2650 |
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