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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 Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

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

NPI Number 1366621211
LBN Legal business name ALLERGY & DERMATOLOGY ASSOCIATES OF TIFTON PC
Authorized official HENRY DORMINEY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/29/2007
Last updated 07/26/2013 - About 13 years ago
Identifiers
GA License # 023352
GA Medicaid 000239731A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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