Provider Demographics
NPI:1649224114
Name:ADAMS, KATIA M (MD)
Entity type:Individual
Prefix:DR
First Name:KATIA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:941-847-7919
Practice Address - Street 1:108 PROMINENCE CT STE 200
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6340
Practice Address - Country:US
Practice Address - Phone:706-216-3238
Practice Address - Fax:706-216-5285
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME136892207Q00000X
GA65631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101160300Medicaid
KY64050875Medicaid
KYP00839911OtherRAILROAD MEDICARE
FLKJ487OtherMEDICARE
OH2323186Medicaid
KYP00839911OtherRAILROAD MEDICARE
KY080189335OtherRAILROAD MEDICARE