Provider Demographics
NPI:1760689707
Name:ADAMS, DOUGLAS ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ROBERT
Last Name:ADAMS
Suffix:
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 1:4105 BRIARGATE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3487
Mailing Address - Country:US
Mailing Address - Phone:719-776-7846
Mailing Address - Fax:
Practice Address - Street 1:4105 BRIARGATE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3487
Practice Address - Country:US
Practice Address - Phone:719-776-7846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 390200000X
CO59977207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program