Provider Demographics
NPI:1659399269
Name:ADAMS, KIMBERLY A (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10300 W CHARLESTON BLVD
Mailing Address - Street 2:STE 13 #51
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-5008
Mailing Address - Country:US
Mailing Address - Phone:702-253-9355
Mailing Address - Fax:702-982-8542
Practice Address - Street 1:5225 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0159
Practice Address - Country:US
Practice Address - Phone:702-253-9355
Practice Address - Fax:702-253-0009
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVDJ806ZMedicare PIN
NVDJ806YMedicare PIN