TIFTAREA UROLOGY PC NPI 1912068503

NPI Information

  • NPI: 1912068503
  • Provider Name: TIFTAREA UROLOGY, PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 11D0987724
  • Address: 1815 OLD OCILLA RD
    TIFTON, GA
    ZIP 31794
  • Phone: (229) 391-3535

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NPI Details

TIFTAREA UROLOGY, PC is a specialist in Tifton, GA. The provider is 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. TIFTAREA UROLOGY, PC NPI is 1912068503. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1815 OLD OCILLA RD
TIFTON, GA
ZIP 31794-617
Phone: (229) 391-3535
Fax: (229) 391-3529

The provider's authorized official is Jeffry J Peters .
The authorized official title is Vice President and has the following contact phone number (229) 391-3535.

The CLIA number assigned to this NPI record is 11D0987724 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 5/13/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist040514GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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