Individual
MR. JERRY M ADAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1027 E MAIN ST, MORRISTOWN, TN 37814-6632
(423) 581-5984
(423) 581-0984
Mailing address
PO BOX 1718, MORRISTOWN, TN 37816-1718
(423) 581-5987
(423) 581-0984
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN0000097158
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3625145
—
TN
01
—
4095611
BCBS
TN
Enumeration date
09/13/2005
Last updated
07/08/2007
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