Individual
MADISON AYERS HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
364 CLIFTON RD, ATLANTA, GA 30322-3927
(404) 778-3900
Mailing address
1836 DELPHINE DR, DECATUR, GA 30032-3927
(478) 607-1114
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
12910
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12910
GEORGIA MEDICAL BOARD
GA
Enumeration date
10/16/2024
Last updated
02/27/2025
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