NPI age
19 years
Enumerated 2006-11-09
● Active
Type 1 · Individual
Dale Broome, PA
Broome is 1 of 32 physician assistant providers in Tifton and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-06-07
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
19 years
↑ 11 yr above median (8 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
0
24% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-11Enumerated in NPPES
2006
2026
Where they practice
Practice location
901 18th St E
Tifton, GA 317943648
Mailing address
1623 Madison Ave
Tifton, GA 317943757
Additional practice locations
1 secondary location on file with NPPES.
Location 2
1623 Madison Ave
Tifton, GA 317943757
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 004286 | LICENSE NUMBER |
| 05 (GA) | 584584358A |
Practice context
Part of a multi-provider practice. 169 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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