Provider Demographics
NPI:1588619530
Name:AMADOR, JORGE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:A
Last Name:AMADOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JORGE
Other - Middle Name:A
Other - Last Name:AMADOR MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8 VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1902
Mailing Address - Country:US
Mailing Address - Phone:770-400-8443
Mailing Address - Fax:770-400-8445
Practice Address - Street 1:60 OAK HILL BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2314
Practice Address - Country:US
Practice Address - Phone:770-400-8444
Practice Address - Fax:770-400-8445
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8415207Q00000X
GA058842207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
9500012OtherHUMANA INSURANCE
GA58842OtherGA MEDICAL LICENCE
HB25P08415 HIFPOtherHUMANA HEALTH PLUS
HB25P08415 HIFPOtherHUMANA HEALTH PLUS
D95883Medicare UPIN