Tift Regional Medical Center D/B/A South Georgia Vascular Clinic

LBN: South Georgia Vascular Clinic
Tift Regional Medical Center D/B/A South Georgia Vascular Clinic is an health care organization with primary practice located at 901 18Th St E , Tifton GA 31794-3648. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as the primary health care specialty. South Georgia Vascular Clinic can be contacted via phone (229) 382-9733, or through Crum, Dennis via phone (229) 353-6146.

Contact Information

Primary practice address
901 18Th St E Tifton GA 31794-3648
Phone: (229) 382-9733
Fax: (229) 387-6161
Website:
Map and Directions
Authorized official contact:
Name: Crum, Dennis
Phone: (229) 353-6146

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 031466 Georgia

Profile Details

NPI number 1144454059
LBN Legal business name South Georgia Vascular Clinic
DBA Doing business as Tift Regional Medical Center D/B/A South Georgia Vascular Clinic
Authorized official Crum, Dennis
Entity Organization
Organization subpart 1 No
Enumeration date May 6th, 2009
Last updated May 6th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144454059 NPPES
Georgia Other 1003883612 NPI/WILLIAM KAISER, MD
Georgia Other 1154356889 NPI/WILLIAM KAISER, MD
Georgia MEDICAID 205810921C NPI/WILLIAM KAISER, MD

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