Robert Adams, MD
Individual provider Active NPI Psychologist · Jackson, MS
NPI 1003830563 · NPPES record last updated Dec 8, 2015
Key facts
- NPI
- 1003830563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 41677 (MS)
- Practice address
- 1600 N State St
Ste 400
Jackson, MS 39202-1689 - Phone
- (601) 944-1717
- Fax
- (601) 944-9780
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41677 | MS | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi Methodist Hospital & Rehabilitation Center, Inc. | Past | Accepting new patients | |
| William S Cook Jr M D P a | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 41677 | MS | Yes |
| Neurology Physician | 2084N0400X | 41677 | MS |
Addresses
Primary practice location
1600 N State St
Ste 400
Jackson, MS 39202-1689
Mailing address
1225 N State St
Jackson, MS 39202-2064
Phone (601) 968-1000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03731341 | Medicaid | MS |
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.