MEDICARE: DR. JOHN ALFRED ADAMS O.D.

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	1775DT	KY
2	152W00000X	Optometrist	TUV008252	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497900070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ALFRED ADAMS O.D.

Provider Business Mailing Address
First Line	:	450 MARGARET ST
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-1755
Country	:	US
Telephone Number	:	518-566-2020
Fax Number	:	518-561-5390

Provider Business Practice Location Address
First Line	:	1462 W LEXINGTON AVE
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1294
Country	:	US
Telephone Number	:	859-737-5599
Fax Number	:	859-737-0650

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

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	07/21/2015

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