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General NPI Number Information
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NPI Number | 1942556311
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Entity Type | Individual
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Provider Name | JASPER WINTON ADCOCK DPT, OTR/L, RHIA
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Gender | Male
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Dates
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Enumeration Date | 08/03/2012
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1074 HIGHWAY 13 N
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City | BRANDON
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State | MS
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Zip | 39042-8568
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Country | US
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Telephone | 601-825-0101
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Fax | 16-822-0541
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Provider Business Mailing Address
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Address Line | 48 SCR 58
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City | MIZE
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State | MS
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Zip | 39116-5703
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Country | US
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Telephone | 601-477-2102
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Fax | 601-822-0541
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5208
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5208
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License Number State | MS
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Taxonomy #6
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2664
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License Number State | MS
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Taxonomy #7
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2664
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License Number State | MS
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