Healthcare Provider Details

I. General information

NPI: 1356655302
Provider Name (Legal Business Name): PHYSICIAN SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905 KNIGHTDALE BLVD
KNIGHTDALE NC
27545-6505
US

IV. Provider business mailing address

2709 COXINDALE DR
RALEIGH NC
27615-3870
US

V. Phone/Fax

Practice location:
  • Phone: 919-261-8760
  • Fax: 919-261-8765
Mailing address:
  • Phone: 919-261-8760
  • Fax: 919-261-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT S. ADAMS
Title or Position: OWNER
Credential: M.D.
Phone: 919-261-8760