Healthcare Provider Details
I. General information
NPI: 1619290756
Provider Name (Legal Business Name): WILLIAM M ADAMS JR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6209 POPLAR AVE SUITE 200
MEMPHIS TN
38119-4712
US
IV. Provider business mailing address
6209 POPLAR AVE SUITE 200
MEMPHIS TN
38119-4712
US
V. Phone/Fax
- Phone: 901-761-4844
- Fax: 901-761-6929
- Phone: 901-761-4844
- Fax: 901-761-6929
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | 4378 |
| License Number State | TN |
VIII. Authorized Official
Name: DR.
WILLIAM
M
ADAMS
JR.
Title or Position: MD/OWNER
Credential: MD
Phone: 901-761-4844