Provider Demographics
NPI:1578141131
Name:ADAMS, WILLIAM MIMS (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MIMS
Last Name:ADAMS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-4537
Mailing Address - Country:US
Mailing Address - Phone:318-574-5080
Mailing Address - Fax:318-574-5052
Practice Address - Street 1:900 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-4537
Practice Address - Country:US
Practice Address - Phone:318-574-5080
Practice Address - Fax:318-574-5052
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA342840207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine