Provider Demographics
NPI:1144073818
Name:AD OF GEORGIA PC
Entity type:Organization
Organization Name:AD OF GEORGIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-851-4642
Mailing Address - Street 1:8440 HOLCOMB BRIDGE RD STE 560
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1838
Mailing Address - Country:US
Mailing Address - Phone:888-851-4642
Mailing Address - Fax:
Practice Address - Street 1:1945 BEVERLY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2034
Practice Address - Country:US
Practice Address - Phone:888-851-4642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty