Provider Demographics
NPI:1285698480
Name:ADAMS, JUDONN THEOPHILOUS (MD)
Entity type:Individual
Prefix:DR
First Name:JUDONN
Middle Name:THEOPHILOUS
Last Name:ADAMS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5536 FLAT SHOALS PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-5408
Mailing Address - Country:US
Mailing Address - Phone:678-518-9691
Mailing Address - Fax:678-518-9692
Practice Address - Street 1:120 CARNEGIE PL
Practice Address - Street 2:SUITE 104
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7912
Practice Address - Country:US
Practice Address - Phone:770-460-5667
Practice Address - Fax:770-460-6710
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2016-07-05
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Provider Licenses
StateLicense IDTaxonomies
GA033506207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000445068DMedicaid
GA000445068DMedicaid