Provider Demographics
NPI:1356685564
Name:ADAMSON, GERALD PATRICK (DMIN)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:PATRICK
Last Name:ADAMSON
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WYANDOTTE RD
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-7653
Mailing Address - Country:US
Mailing Address - Phone:270-230-8994
Mailing Address - Fax:
Practice Address - Street 1:110 WYANDOTTE RD
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-7653
Practice Address - Country:US
Practice Address - Phone:270-230-8994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral