Healthcare Provider Details

I. General information

NPI: 1366474538
Provider Name (Legal Business Name): SERRHEL G ADAMS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 WILLOW CREEK DR STE 203B
SPRINGDALE AR
72762-8708
US

IV. Provider business mailing address

5501 WILLOW CREEK DR STE 203B
SPRINGDALE AR
72762-8708
US

V. Phone/Fax

Practice location:
  • Phone: 479-419-9393
  • Fax: 479-419-9513
Mailing address:
  • Phone: 479-419-9393
  • Fax: 479-419-9513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberE5538
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: