Provider Demographics
NPI:1710095724
Name:ADAMSON, KATHERINE JUSTEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:JUSTEN
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:23520 MAJESTIC VW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7723
Mailing Address - Country:US
Mailing Address - Phone:210-481-1122
Mailing Address - Fax:210-481-1123
Practice Address - Street 1:12TH MEDICAL GROUP
Practice Address - Street 2:221 3RD STREET WEST
Practice Address - City:RANDOLPH AIR FORCE BASE
Practice Address - State:TX
Practice Address - Zip Code:78150
Practice Address - Country:US
Practice Address - Phone:210-652-6403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical