Healthcare Provider Details

I. General information

NPI: 1235132457
Provider Name (Legal Business Name): BRENT E ADAMSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 CENTRAL AVE
KEARNEY NE
68847-2944
US

IV. Provider business mailing address

816 22ND AVE SUITE 100
KEARNEY NE
68845-2206
US

V. Phone/Fax

Practice location:
  • Phone: 308-865-2512
  • Fax: 308-865-2506
Mailing address:
  • Phone: 308-865-2808
  • Fax: 308-455-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number04-25566
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number19613
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: