Provider Demographics
NPI:1649302365
Name:RADFORD, MONICA ALLYSON (MD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:ALLYSON
Last Name:RADFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:RADFORD
Other - Last Name:BARBOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2114 SINCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-0569
Mailing Address - Country:US
Mailing Address - Phone:404-784-5810
Mailing Address - Fax:
Practice Address - Street 1:997 ST. SEBASTIAN WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912
Practice Address - Country:US
Practice Address - Phone:762-375-3284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045110207R00000X, 2084P0800X
CT043069207R00000X, 2084P0800X
TXS5318207R00000X
GA451102084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherN/A