Healthcare Provider Details

I. General information

NPI: 1790821304
Provider Name (Legal Business Name): DAVID A ADAMS BC-HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S SAGE AVE
MOBILE AL
36606-3604
US

IV. Provider business mailing address

319 S SAGE AVE
MOBILE AL
36606-3604
US

V. Phone/Fax

Practice location:
  • Phone: 251-479-9409
  • Fax: 251-476-9368
Mailing address:
  • Phone: 251-479-9409
  • Fax: 251-476-9368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number002707
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: