Provider Demographics
NPI:1992900039
Name:ADL SOLUTIONS
Entity type:Organization
Organization Name:ADL SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-936-3515
Mailing Address - Street 1:1050 N FLOWOOD DR
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9738
Mailing Address - Country:US
Mailing Address - Phone:601-936-3515
Mailing Address - Fax:601-936-0705
Practice Address - Street 1:1050 N FLOWOOD DR
Practice Address - Street 2:SUITE A-1
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9738
Practice Address - Country:US
Practice Address - Phone:601-936-3515
Practice Address - Fax:601-936-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS500001836 C02840Medicare ID - Type Unspecified