Adams, Audie Macon

Adams, Audie Macon is an sole proprietor health care provider with primary practice located at 440 Gwen Rd , Senatobia MS 38668-6362. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Adams, Audie Macon can be contacted via phone (662) 562-8720.

Contact Information

Primary practice address
440 Gwen Rd Senatobia MS 38668-6362
Fax: (662) 562-0054
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 04949 Mississippi

Profile Details

NPI number 1811074511
LBN Legal business name Adams, Audie Macon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811074511 NPPES
Mississippi MEDICAID 00118140

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