Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | R6B34 | MO |
NPI | 1013015106 |
---|---|
Provider Name | Allen G Adams |
First Address | Kansas City, MO 64105-2017 |
Second Address | Saint Joseph, MO 64501-2702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 04/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201831138 | (05) | MO |
A10505 | (02) | MO |