Provider Demographics
NPI:1427137504
Name:ADLER, JODI LYNN (DO)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:ADLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-1969
Mailing Address - Country:US
Mailing Address - Phone:252-757-1487
Mailing Address - Fax:
Practice Address - Street 1:315 W 2ND ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1969
Practice Address - Country:US
Practice Address - Phone:252-757-1487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000-00345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1335XOtherBCBS OF NC
NC1335XOtherBCBS OF NC
NC5K706Medicare ID - Type Unspecified