Provider Demographics
NPI:1093747941
Name:ADAMS, ROBERT RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RALPH
Last Name:ADAMS
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 1:1056 OAKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2910
Mailing Address - Country:US
Mailing Address - Phone:931-544-6002
Mailing Address - Fax:
Practice Address - Street 1:MARION VETERANS ADMINISTRATION MEDICAL CENTER
Practice Address - Street 2:2620 PERKINS CREEK DR (PADUCAH CBOC)
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001
Practice Address - Country:US
Practice Address - Phone:866-289-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD156312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND93225Medicare UPIN