Provider Demographics
NPI:1245363993
Name:ADAMS, STEPHEN RICHARD (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:RICHARD
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3800 S. NATIONAL AVE
Mailing Address - Street 2:STE. 540
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5284
Mailing Address - Country:US
Mailing Address - Phone:417-269-9950
Mailing Address - Fax:417-269-9959
Practice Address - Street 1:3525 S. NATIONAL AVE
Practice Address - Street 2:#101
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7315
Practice Address - Country:US
Practice Address - Phone:417-269-9950
Practice Address - Fax:417-269-9959
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2013-06-20
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Provider Licenses
StateLicense IDTaxonomies
MOR4N31207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE95060Medicare UPIN