MEDICARE: ADAMS FAMILY MEDICAL CENTER, INC.

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	208D00000X	General Practice Physician	34-00-3883	OH

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	:	1912965674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAMS FAMILY MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	200 BRADENTON AVE
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-7515
Country	:	US
Telephone Number	:	614-793-1980
Fax Number	:	614-793-1985

Provider Business Practice Location Address
First Line	:	480 S JEFFERSON AVE
Second Line	:	SUITE 500
City	:	PLAIN CITY
State	:	OH
Zip	:	43064-4137
Country	:	US
Telephone Number	:	614-873-3434
Fax Number	:	614-873-4953

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN E. ADAMS II
Credential	:	D.O.
Telephone Number	:	614-873-3434

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	12/15/2009

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