Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ricky O Tatum, PAC

Individual provider Physician Assistant · NPI 1073837555

Ricky O Tatum, PAC is a Physician Assistant in Waycross, Georgia. Qualified in 1979, 47 years ago. Practices with Ware Express Care, LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
47
Licensed in
GA
In the registry since
2010
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

306 Isabella St
Waycross, GA 31501-3636
Phone: (912) 285-9990
Fax: (912) 338-8931
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 002235 (GA)

Record details

NPI number1073837555
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedMarch 26, 2010
Last updated in NPPESJanuary 8, 2026
Certification dateJanuary 8, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1979 (47 years in practice)
Group practice Ware Express Care, Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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