Provider Demographics
NPI:1932302205
Name:ADAMS, PATVIN DEAN-LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:PATVIN
Middle Name:DEAN-LLOYD
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:PO BOX 415000 LBX 410756
Mailing Address - Street 2:PATVIN ADAMS, MD, PLLC
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37241-0756
Mailing Address - Country:US
Mailing Address - Phone:318-798-4539
Mailing Address - Fax:318-798-4601
Practice Address - Street 1:315 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3719
Practice Address - Country:US
Practice Address - Phone:318-590-1073
Practice Address - Fax:318-590-1074
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1369519Medicaid
LA4N603DM27Medicare PIN
LA4N603Medicare PIN
LA4N603DT25Medicare PIN