Provider Demographics
NPI:1780651489
Name:STAGE, ADAM CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:STAGE
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 1:8001 YOUREE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2341
Mailing Address - Country:US
Mailing Address - Phone:182-127-3353
Mailing Address - Fax:318-212-7336
Practice Address - Street 1:8001 YOUREE DR STE 500
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2341
Practice Address - Country:US
Practice Address - Phone:318-212-7335
Practice Address - Fax:318-212-7336
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200689208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology