Basic Information
| Provider Information | |||||||||
| NPI: | 1003234584 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DULEY | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 JEFFERSON AVE | ||||||||
| Address2: | 5TH FLOOR MERCY PHO/CVO | ||||||||
| City: | TOLEDO | ||||||||
| State: | KY | ||||||||
| PostalCode: | 436047101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192519830 | ||||||||
| FaxNumber: | 4192511826 | ||||||||
| Practice Location | |||||||||
| Address1: | 1530 LONE OAK RD | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420037901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704442444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2014 | ||||||||
| LastUpdateDate: | 07/25/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 390200000 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 49897 | KY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.