Healthcare Provider Details

I. General information

NPI: 1801090469
Provider Name (Legal Business Name): ADAM LESTER ESHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4439 STATE ROUTE 159 STE 260
CHILLICOTHEE OH
45601-7502
US

IV. Provider business mailing address

4439 STATE ROUTE 159 STE 260
CHILLICOTHEE OH
45601-7502
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-4370
  • Fax: 740-779-4379
Mailing address:
  • Phone: 740-779-4370
  • Fax: 740-779-4379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35.097987
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: