Provider Demographics
NPI:1457472094
Name:ADAMS, JOHN BLOUNT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BLOUNT
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7247
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-7247
Mailing Address - Country:US
Mailing Address - Phone:706-324-3243
Mailing Address - Fax:706-324-3835
Practice Address - Street 1:2300 MANCHESTER EXPY
Practice Address - Street 2:STE C001
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6802
Practice Address - Country:US
Practice Address - Phone:706-324-3243
Practice Address - Fax:706-324-3835
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060696208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I022407OtherMEDICARE PTAN
GA127632899Medicaid
AL149957Medicaid