National Provider Identifier Database

ALLERGY DERMATOLOGY ASSOCIATES OF TIFTON PC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

ALLERGY & DERMATOLOGY ASSOCIATES OF TIFTON PC
820 LOVE AVENUE
SUITE A
TIFTON, GA31794
Phone: 229-382-3720
Fax: 229-382-3722
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for ALLERGY & DERMATOLOGY ASSOCIATES OF TIFTON PC

NPI Number 1366621211
Legal business name
LBN
ALLERGY & DERMATOLOGY ASSOCIATES OF TIFTON PC
Authorized official HENRY DORMINEY - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/29/2007
Last updated 07/26/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 023352
  • GA Medicaid: 000239731A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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