Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 20774 | MS |
NPI | 1114969011 |
---|---|
Provider Name | Dr. Craig V Adams |
First Address | Mccomb, MS 39649-0490 |
Second Address | Mccomb, MS 39648-2707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 12/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09537703 | (05) | MS |
344864YQVY | MEDICARE PTAN (01) | MS |
E94594 | (02) | MS |