Provider Demographics
NPI:1235132457
Name:ADAMSON, BRENT E (MD)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:E
Last Name:ADAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 22ND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2206
Mailing Address - Country:US
Mailing Address - Phone:308-865-2808
Mailing Address - Fax:308-455-3970
Practice Address - Street 1:3500 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2944
Practice Address - Country:US
Practice Address - Phone:308-865-2512
Practice Address - Fax:308-865-2506
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-25566207X00000X
NE19613207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA536391Medicaid
NE200020173OtherRAILROAD MEDICARE
KS100167910Medicaid
KS390450OtherFIRST GUARD
KS200041575OtherRAILROAD MEDICARE
KS47644OtherBCBS
NE6245OtherBCBS
13947OtherMIDLANDS CHOICE
NE265185ADMedicare PIN
KS47644OtherBCBS
KS390450OtherFIRST GUARD