Provider Demographics
NPI:1841685112
Name:ADAMS, JOSEPH WALTER (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WALTER
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 1:804 ENGLISH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-6027
Mailing Address - Country:US
Mailing Address - Phone:252-443-3133
Mailing Address - Fax:252-443-6726
Practice Address - Street 1:804 ENGLISH RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-6027
Practice Address - Country:US
Practice Address - Phone:252-443-3133
Practice Address - Fax:252-443-6726
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50570207Q00000X
390200000X
NC2024-00240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program