Healthcare Provider Details

I. General information

NPI: 1700879293
Provider Name (Legal Business Name): BRADLEY SCOTT ADAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 SW PERKINS AVENUE
PENDLETON OR
97801-3215
US

IV. Provider business mailing address

3207 SW PERKINS AVE
PENDLETON OR
97801-4465
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-4642
  • Fax: 541-276-4975
Mailing address:
  • Phone: 541-276-4642
  • Fax: 541-276-4975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD23266
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: