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General NPI Number Information
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NPI Number | 1679700199
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Entity Type | Organization
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Legal Business Name | CHARLES C. ADAMS, MD PC
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 4085 CLOUD SPRINGS RD
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City | RINGGOLD
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State | GA
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Zip | 30736-8411
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Country | US
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Telephone | 706-861-7377
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Fax | 706-861-7922
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Provider Business Mailing Address
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Address Line | 4085 CLOUD SPRINGS RD
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City | RINGGOLD
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State | GA
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Zip | 30736-8411
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Country | US
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Telephone | 706-861-7377
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Fax | 706-861-7922
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. ELLEN M WINCHEL
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Credential |
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Telephone | 706-861-7377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD0000020333
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 045378
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License Number State | GA
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