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Individual

DR. AUDIE MACON ADAMS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
440 GWEN RD, SENATOBIA, MS 38668-6362
(662) 562-8720
(662) 562-0054
Mailing address
440 GWEN RD, SENATOBIA, MS 38668-6362
(662) 562-8720
(662) 562-0054

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04949
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00118140
MS
Enumeration date
11/01/2006
Last updated
07/09/2007
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