Healthcare Provider Details

I. General information

NPI: 1962525535
Provider Name (Legal Business Name): JOSEPH A ADAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MED TECH PKWY STE 160
JOHNSON CITY TN
37604-2651
US

IV. Provider business mailing address

PO BOX 632476
CINCINNATI OH
45263-2476
US

V. Phone/Fax

Practice location:
  • Phone: 423-794-5560
  • Fax: 423-794-1827
Mailing address:
  • Phone: 234-794-5560
  • Fax: 423-794-1827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD437975
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD42020
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier11993362
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAQH
# 2
IdentifierQ017742
Identifier TypeMEDICAID
Identifier StateTN
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: