Mr Michael Stephan Adams Sr, MD | |
2400 Mount Zion Pkwy, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236-2500 | |
(770) 603-3668 | |
(404) 564-6734 |
Full Name | Mr Michael Stephan Adams Sr |
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Gender | Male |
Speciality | Pediatrics |
Location | 2400 Mount Zion Pkwy, Jonesboro, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629062195 | NPI | - | NPPES |
000503566A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 034102 (Georgia) | Primary |
Entity Name | The Southeast Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
Mailing Address | Practice Location Address |
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Mr Michael Stephan Adams Sr, MD 3495 Piedmont Rd Ne, Nine Piedmont Center, Atlanta, GA 30305-1717 Ph: (404) 364-7070 | Mr Michael Stephan Adams Sr, MD 2400 Mount Zion Pkwy, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236-2500 Ph: (770) 603-3668 |
Mark C Becknell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2400 Mount Zion Pkwy, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 Phone: 770-603-3614 | |
Gary J Hirsch, PAC Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2400 Mount Zion Parkway, Pediatrics Health Care Team A, Jonesboro, GA 30236 Phone: 770-603-3649 | |
Dr. Tarissa Mitchell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2400 Mount Zion Pkwy, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 Phone: 770-603-3612 | |
Dr. Maria Teresa A Coleman, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 236 Arrowhead Blvd, Jonesboro, GA 30236 Phone: 770-478-9240 Fax: 770-478-0318 | |
Supriya Hattangadi Kasi, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 236 Arrowhead Blvd, Jonesboro, GA 30236 Phone: 770-478-9240 | |
Lashawnda Doster Jones, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2400 Mount Zion Pkwy, Jonesboro, GA 30236 Phone: 404-365-0966 | |
Dr. Taisha K Okafor, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 236 Arrowhead Blvd, Jonesboro, GA 30236 Phone: 770-478-9240 Fax: 770-478-0318 |