Provider Demographics
NPI:1104830330
Name:ADAMS, BILL (DC, DACBR)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DC, DACBR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 PEACH ST UNIT 7 # 323
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-7718
Mailing Address - Country:US
Mailing Address - Phone:484-634-6925
Mailing Address - Fax:866-512-5215
Practice Address - Street 1:6660 PEACH ST UNIT 7 # 323
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-7718
Practice Address - Country:US
Practice Address - Phone:484-634-6925
Practice Address - Fax:866-512-5215
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007794L111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019504270002Medicaid
PA2574808OtherAETNA
PA433012ADAOtherUNITED HEALTHCARE
PAAD916544OtherBLUE SHIELD
PA1038321OtherASHN/CAPITAL BLUE CROSS
PA433012ADAOtherUNITED HEALTHCARE
PA2574808OtherAETNA