Basic Information
| Provider Information | |||||||||
| NPI: | 1114333648 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BETZ | ||||||||
| FirstName: | ADAM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9228 S MINGO RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741335722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9185920999 | ||||||||
| FaxNumber: | 9185921021 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 ROSE ST | ||||||||
| Address2: | ANESTHESIOLOGY | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592180069 | ||||||||
| FaxNumber: | 8593231080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2014 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LC0200X | 51444 | KY | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207RC0200X | 34492 | OK | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207L00000X | 51444 | KY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.