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NPI Code Detail

MEDICARE: MR. EDWARD THOMAS ADAMS JR. SLP

MEDICARE: MR. EDWARD THOMAS ADAMS JR. SLP
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
1235Z00000XSpeech-Language PathologistSLPL5125AZ

General Provider Information

NPI Number : 1720095698
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD THOMAS ADAMS JR. SLP
Provider Business Mailing Address
First Line : 5650 E. JULIUS STRAVENUE
Second Line :
City : TUCSON
State : AZ
Zip : 85712-3709
Country : US
Telephone Number : 520-270-4816
Fax Number : 520-207-2632
Provider Business Practice Location Address
First Line : 5656 E GRANT RD
Second Line :
City : TUCSON
State : AZ
Zip : 85712-2210
Country : US
Telephone Number : 520-885-9567
Fax Number : 520-885-9568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 07/08/2007

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Directions to “ MR. EDWARD THOMAS ADAMS JR. SLP” Practice Location

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