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General NPI Number Information
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NPI Number | 1447572227
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Entity Type | Organization
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Legal Business Name | SIMON B ADAMES MD PC
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 3386 GREYSTONE WAY
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City | VALDOSTA
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State | GA
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Zip | 31605
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Country | US
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Telephone | 229-219-7826
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Fax | 229-219-7407
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Provider Business Mailing Address
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Address Line | 3386 GREYSTONE WAY
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City | VALDOSTA
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State | GA
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Zip | 31605
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Country | US
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Telephone | 229-219-7826
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Fax | 229-219-7407
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Authorized Official
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Title or Position | MD/OWNER
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Name | MR. SIMON B ADAMES
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Credential | MD
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Telephone | 229-219-7826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 045155
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License Number State | GA
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