Provider Demographics
NPI:1518477785
Name:ADAMS, CHRISTY JO MORGAN
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:JO MORGAN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2384 TILSON RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-6276
Mailing Address - Country:US
Mailing Address - Phone:321-297-9167
Mailing Address - Fax:
Practice Address - Street 1:6285 GARDEN WALK BLVD STE A
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2625
Practice Address - Country:US
Practice Address - Phone:770-991-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8490363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant