Provider Demographics
NPI:1336127547
Name:ADAMS, WILLIAM M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:ADAMS
Suffix:JR
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 1:1068 CRESTHAVEN RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119
Mailing Address - Country:US
Mailing Address - Phone:901-761-4844
Mailing Address - Fax:901-761-6929
Practice Address - Street 1:1068 CRESTHAVEN RD
Practice Address - Street 2:SUITE #200
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119
Practice Address - Country:US
Practice Address - Phone:901-761-4844
Practice Address - Fax:901-761-6929
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD004378208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2005655OtherBSBS
MS00115539Medicaid
TN3154408Medicaid
TNB02516Medicare UPIN
TN3154408Medicare ID - Type Unspecified
TN2005655OtherBSBS