Tiftarea Pediatrics

LBN: Tiftarea Pediatrics
Tiftarea Pediatrics is an health care organization with primary practice located at 215 12Th St W , Tifton GA 31794-3923. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Tiftarea Pediatrics can be contacted via phone (912) 690-4043, or through Wilson, Mark via phone (229) 396-5335.

Contact Information

Primary practice address
215 12Th St W Tifton GA 31794-3923
Fax:
Website:
Authorized official contact:
Name: Wilson, Mark Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1154081271
LBN Legal business name Tiftarea Pediatrics
DBA Doing business as
Authorized official Wilson, Mark Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 30th, 2021
Last updated Nov 2nd, 2022 - about 4 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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