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Individual

DR. BRIAN WILSON ADKISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2212 W. KEARNEY, SPRINGFIELD, MO 65803
(417) 831-8074
(417) 864-6585
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R4P92
MO
207Q00000X
Family Medicine Physician
Primary
R4P92
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811078496
MO
Enumeration date
10/18/2006
Last updated
10/02/2014
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