Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 390200000 | TN |
Y | 207P00000X | Emergency Physician | 49897 | KY |
NPI | 1003234584 |
---|---|
Provider Name | Dr. Adam Duley |
First Address | Toledo, KY 43604-7101 |
Second Address | Paducah, KY 42003-7901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 25/07/2017 |