Provider Demographics
NPI:1063502391
Name:ADAMSON, RANDALL S (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:S
Last Name:ADAMSON
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 1:125 HOLLY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9423
Mailing Address - Country:US
Mailing Address - Phone:919-552-8011
Mailing Address - Fax:919-557-1285
Practice Address - Street 1:125 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9423
Practice Address - Country:US
Practice Address - Phone:919-552-8011
Practice Address - Fax:919-557-1285
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085K2Medicaid
NC2456382Medicare ID - Type Unspecified