Provider Demographics
NPI:1710060033
Name:ADAMS, EMILY SUZANNE (PAC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUZANNE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 INDIANAPOLIS ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135
Mailing Address - Country:US
Mailing Address - Phone:765-653-8453
Mailing Address - Fax:765-653-8493
Practice Address - Street 1:1145 INDIANAPOLIS ROAD
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135
Practice Address - Country:US
Practice Address - Phone:765-653-8453
Practice Address - Fax:765-653-8493
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000681A363A00000X
IN1000681A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine