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General NPI Number Information
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NPI Number | 1669749305
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Entity Type | Organization
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Legal Business Name | DR. JOHN C. ADAMS, JR., PC
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 102 S ZETTEROWER AVE
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City | STATESBORO
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State | GA
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Zip | 30458-4816
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Country | US
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Telephone | 912-764-6731
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Fax | 912-764-6731
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Provider Business Mailing Address
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Address Line | 102 S ZETTEROWER AVE
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City | STATESBORO
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State | GA
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Zip | 30458-4816
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Country | US
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Telephone | 912-764-6731
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Fax | 912-764-6731
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN C ADAMS JR.
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Credential | ED. D.
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Telephone | 912-764-6731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 359
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License Number State | GA
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