Provider Demographics
NPI:1104823020
Name:ADAMS, CECILIA D (MD)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:D
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6637 SUMMER KNOLL CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2875
Mailing Address - Country:US
Mailing Address - Phone:901-372-5260
Mailing Address - Fax:901-386-8726
Practice Address - Street 1:6637 SUMMER KNOLL CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2875
Practice Address - Country:US
Practice Address - Phone:901-372-5260
Practice Address - Fax:901-386-8726
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3851339Medicaid
TN4091779OtherBLUE CROSS BLUE SHIELD
TN3851336Medicaid
TNH28297Medicare UPIN
TN3851339Medicaid
TN3851336Medicaid