Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 239282 | NY |
N | 208600000X | Surgeon | 239282 | NY |
N | 208200000X | Surgeon | 239282 | NY |
N | 208600000X | Surgeon | 239282 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | A-1678-12 | NM |
NPI | 1255536686 |
---|---|
Provider Name | Dr. Jason Phillip Adams |
First Address | Farmington, NM 87401 |
Second Address | Farmington, NM 87401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2007 |
Last Update Date | 26/10/2020 |