Individual
DOUGLAS ADKISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 TAKOMA AVE, GREENEVILLE, TN 37743-4647
(423) 278-1743
(423) 278-1930
Mailing address
PO BOX 1869, ATTN: DANIELLE BOLICK, PROVIDER ENROLLMENT, FLETCHER, NC 28732-1869
(828) 687-5616
(828) 650-8076
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
42193
TN
207RC0000X
Cardiovascular Disease Physician
42193
TN
208M00000X
Hospitalist Physician
Primary
42193
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3001417
—
TN
01
—
4309055
BCBST
TN
Enumeration date
01/04/2007
Last updated
06/18/2015
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