Individual
TIMOTHY ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 389-4500
(601) 663-7721
Mailing address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 389-4500
(601) 663-7721
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001039A
IN
213E00000X
Podiatrist
80139
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000543884
ANTHEM
IN
05
—
01270333
—
MS
05
—
200861050
—
IN
01
—
P01192556
RAILROAD MEDICARE
IN
Enumeration date
07/10/2006
Last updated
02/17/2015
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