MEDICARE: WILLIAM JEPTHA ADAMS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	NC970	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09011	OTHER	NC	BLUE CROSSBLUESHIELD

General Provider Information

NPI Number	:	1497826986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM JEPTHA ADAMS OD

Provider Business Mailing Address
First Line	:	PO BOX 1916
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948-1916
Country	:	US
Telephone Number	:	252-441-4872
Fax Number	:	252-441-7812

Provider Business Practice Location Address
First Line	:	1004 S. CROATAN HIGHWAY
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948
Country	:	US
Telephone Number	:	252-441-4872
Fax Number	:	252-441-7812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	10/30/2008

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Directions to “ WILLIAM JEPTHA ADAMS OD” Practice Location

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