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NPI Code Detail

MEDICARE: ADAM DOUGLAS PAXTON

MEDICARE: ADAM DOUGLAS PAXTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist
2225100000XPhysical Therapist9527SC

General Provider Information

NPI Number : 1326511890
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM DOUGLAS PAXTON
Provider Business Mailing Address
First Line : PO BOX 6069
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29171-6069
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1320 DUTCH FORK RD STE A
Second Line :
City : IRMO
State : SC
Zip : 29063-8825
Country : US
Telephone Number : 803-314-5450
Fax Number : 803-536-1404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2019
Last Update Date : 03/17/2025

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Directions to “ ADAM DOUGLAS PAXTON ” Practice Location

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