Provider Demographics
NPI:1003885328
Name:ADAMS, RONALD KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:KEITH
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 SPRING ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3636
Mailing Address - Country:US
Mailing Address - Phone:517-783-5805
Mailing Address - Fax:517-783-4287
Practice Address - Street 1:3350 SPRING ARBOR RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3636
Practice Address - Country:US
Practice Address - Phone:517-783-5805
Practice Address - Fax:517-783-4287
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIRA005983OtherBCBS REFERRING NUMBER
MI950C85224Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MIRA005983OtherBCBS REFERRING NUMBER