Healthcare Provider Details

I. General information

NPI: 1679676092
Provider Name (Legal Business Name): DR. CHRISTOPHER BARTON ADAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1685 MARS HILL ROAD NW BLDG 200 STE 200
ACWORTH GA
30101
US

IV. Provider business mailing address

1685 MARS HILL ROAD NW BLDG 200 STE 200
ACWORTH GA
30101
US

V. Phone/Fax

Practice location:
  • Phone: 770-919-0930
  • Fax: 770-919-2309
Mailing address:
  • Phone: 770-919-0930
  • Fax: 770-919-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10720
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: