Provider Demographics
NPI:1821518655
Name:ADAMS, REBECCA JO (DO)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JO
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6203
Practice Address - Street 1:100 N EAGLE CREEK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1805
Practice Address - Country:US
Practice Address - Phone:859-258-4000
Practice Address - Fax:859-258-5177
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYR4321207Q00000X
KY04752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0407453Medicaid
KY7100670310Medicaid