Provider Demographics
NPI:1396963732
Name:ADAMS, REX MCKINLEY (DMD)
Entity type:Individual
Prefix:DR
First Name:REX
Middle Name:MCKINLEY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 5TH ST SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-4043
Mailing Address - Country:US
Mailing Address - Phone:256-734-6071
Mailing Address - Fax:256-734-6101
Practice Address - Street 1:513 5TH ST SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-4043
Practice Address - Country:US
Practice Address - Phone:256-734-6071
Practice Address - Fax:256-734-6101
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL53991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1914098Medicare UPIN
AL51535945Medicare UPIN