Provider Demographics
NPI:1083743884
Name:YEISER, ADRIAN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:JAMES
Last Name:YEISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 E PARRISH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-3258
Mailing Address - Country:US
Mailing Address - Phone:270-688-3371
Mailing Address - Fax:270-688-3370
Practice Address - Street 1:811 E PARRISH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3258
Practice Address - Country:US
Practice Address - Phone:270-688-3371
Practice Address - Fax:270-688-3370
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42749207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000623774OtherANTHEM # WITH COOP HEALTH
KY7100088780Medicaid
KY000000623774OtherANTHEM # WITH COOP HEALTH