Provider Demographics
NPI:1639391956
Name:HARRINGTON-MERRIWEATHER, ADRIENNE NICOLE (MD)
Entity Type:Individual
Prefix:MISS
First Name:ADRIENNE
Middle Name:NICOLE
Last Name:HARRINGTON-MERRIWEATHER
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 1:13570 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:GA
Mailing Address - Zip Code:30752-2012
Mailing Address - Country:US
Mailing Address - Phone:706-956-2665
Mailing Address - Fax:706-657-2958
Practice Address - Street 1:2009 OLD LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3510
Practice Address - Country:US
Practice Address - Phone:706-866-5520
Practice Address - Fax:706-657-2958
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522939Medicaid