Healthcare Provider Details

I. General information

NPI: 1699774604
Provider Name (Legal Business Name): PAUL H. ADAMSON D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 NE LAWRIE TATUM RD
LAWTON OK
73507-3002
US

IV. Provider business mailing address

1515 NE LAWRIE TATUM RD
LAWTON OK
73507-3002
US

V. Phone/Fax

Practice location:
  • Phone: 580-354-5566
  • Fax:
Mailing address:
  • Phone: 580-354-5566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC-003090-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: