Healthcare Provider Details

I. General information

NPI: 1366590747
Provider Name (Legal Business Name): ADAMSVILLE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3699 BAKERS FERRY RD SW
ATLANTA GA
30331
US

IV. Provider business mailing address

99 JESSE HILL JR DR ROOM 402
ATLANTA GA
30303-3030
US

V. Phone/Fax

Practice location:
  • Phone: 404-699-4215
  • Fax: 404-505-5724
Mailing address:
  • Phone: 404-730-1211
  • Fax: 404-730-1233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: KIM TURNER
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 404-730-1202