Healthcare Provider Details

I. General information

NPI: 1598727778
Provider Name (Legal Business Name): JOHN LAMONT ADAMS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CENTRAL ST
IPSWICH MA
01938-1912
US

IV. Provider business mailing address

156 W MAIN ST
GEORGETOWN MA
01833-1444
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-7263
  • Fax: 978-356-5574
Mailing address:
  • Phone: 978-352-4036
  • Fax: 978-356-5574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2717
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: