Doctor Name: | JERRY W ADAMS |
NPI Number: | 1417042714 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01028871 |
Business Practice Address: | 3351 North Meridian Street Ste 202 Indianapolis, IN - 46208 |
Business Phone Number: | 3179268839 |
Business Fax Number: | 3179268853 |
Mailing Address: | Po Box 88193, INDIANAPOLIS |
State: | IN |
Postal Code: | 46208 |
Phone Number: | 3179268839 |
Fax Number: | 3179268853 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 07/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01028871 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |