Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1998
NPI: 1164456422
Practice Locations (1)
TIFT REGIONAL HEALTH SYSTEM INC
1815 OLD OCILLA RD
TIFTON, GA 317941617
2293915353
Source: CMS National Downloadable File, September 2026.