Ricky O Tatum, PAC

NPI #1073837555 in Waycross, Georgia

Provider Information

NPI Number: 1073837555
Entity Type: Individual
Name: Ricky O Tatum, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Mar 26, 2010
Last Updated: Jan 8, 2026

Practice Location

Address: 306 ISABELLA ST
City: Waycross
State: Georgia
ZIP Code: 31501-3636
Phone: (912) 285-9990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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