Individual
DR. STANLEY W ADKISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
385 RANCH RD, REEDSPORT, OR 97467-1707
(541) 271-2119
(541) 271-9338
Mailing address
600 RANCH RD, REEDSPORT, OR 97467-1720
(541) 271-2171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22387
CO
207R00000X
Internal Medicine Physician
Primary
MD154233
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01223874
—
CO
05
—
500639477
—
OR
01
—
840428757017
ROCKY MOUNTAIN HEALTH PLA
CO
01
—
AD376766
BCBS
CO
Enumeration date
06/18/2006
Last updated
08/11/2023
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