Organization
S R ADCOCK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AUDREY F DUKES (CFO)
(229) 985-8713
Entity
Organization
Contact information
Practice address
1414 S MAIN ST, MOULTRIE, GA 31768-5812
(229) 985-8713
(229) 985-5013
Mailing address
1414 S MAIN ST, MOULTRIE, GA 31768-5812
(229) 985-8713
(229) 985-5013
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
21934
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00264063B
—
GA
Enumeration date
08/25/2005
Last updated
08/22/2020
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