Individual
DR. CHARLES PULLIAM ADAMS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1034 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4123
(904) 354-2114
(904) 354-2122
Mailing address
1034 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4123
(904) 354-2114
(904) 354-2122
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0045165
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00963608A
—
GA
05
—
041611800
—
FL
01
—
15929
BCBS
FL
Enumeration date
07/04/2006
Last updated
07/21/2015
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