Provider Demographics
NPI:1063442127
Name:ADAMS-PICKETT, DONNA LYNN (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:ADAMS-PICKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3652 J DEWEY GRAY CIR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1867
Mailing Address - Country:US
Mailing Address - Phone:706-228-6060
Mailing Address - Fax:706-228-6025
Practice Address - Street 1:3652 J DEWEY GRAY CIR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1867
Practice Address - Country:US
Practice Address - Phone:706-228-6060
Practice Address - Fax:706-228-6025
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA54056207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA855704431AMedicaid
GA855704431AMedicaid
GA16BBCTLMedicare ID - Type UnspecifiedMEDICARE NUMBER