Healthcare Provider Details

I. General information

NPI: 1295863702
Provider Name (Legal Business Name): JOHN L ADAMS OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 05/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CENTRAL ST
IPSWICH MA
01938-1912
US

IV. Provider business mailing address

6 CENTRAL ST
IPSWICH MA
01938-1912
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-7263
  • Fax: 978-356-5574
Mailing address:
  • Phone: 978-356-7263
  • Fax: 978-356-5574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JOHN L ADAMS
Title or Position: OWNER PRESIDENT
Credential: OD
Phone: 978-356-7263