Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 44046 | KY |
NPI | 1033306568 |
---|---|
Provider Name | Dr. William Brodie Adams |
First Address | Louisville, KY 40202-1745 |
Second Address | Louisville, KY 40202-1745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2007 |
Last Update Date | 16/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100145110 | (05) | KY |