MEDICARE: KIMBERLY A ADAMS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9848	NV

General Provider Information

NPI Number	:	1659399269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A ADAMS M.D.

Provider Business Mailing Address
First Line	:	10300 W CHARLESTON BLVD
Second Line	:	STE 13 #51
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-5008
Country	:	US
Telephone Number	:	702-253-9355
Fax Number	:	702-982-8542

Provider Business Practice Location Address
First Line	:	5225 S DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-0159
Country	:	US
Telephone Number	:	702-253-9355
Fax Number	:	702-253-0009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	02/12/2020

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