Provider Demographics
NPI:1154456663
Name:ADAMS, EDWARD JOSPEH (PT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOSPEH
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:EDDIE
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:570 CRESTVIEW LANE
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173
Mailing Address - Country:US
Mailing Address - Phone:205-792-7064
Mailing Address - Fax:
Practice Address - Street 1:1808 GADSDEN HWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3139
Practice Address - Country:US
Practice Address - Phone:205-655-8866
Practice Address - Fax:205-655-8868
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 3075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51531513Medicare ID - Type Unspecified
ALP99196Medicare UPIN