Healthcare Provider Details

I. General information

NPI: 1912965674
Provider Name (Legal Business Name): ADAMS FAMILY MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 S JEFFERSON AVE SUITE 500
PLAIN CITY OH
43064-4137
US

IV. Provider business mailing address

200 BRADENTON AVE
DUBLIN OH
43017-7515
US

V. Phone/Fax

Practice location:
  • Phone: 614-873-3434
  • Fax: 614-873-4953
Mailing address:
  • Phone: 614-793-1980
  • Fax: 614-793-1985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34-00-3883
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0601521
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name: DR. JOHN E. ADAMS II
Title or Position: OWNER
Credential: D.O.
Phone: 614-873-3434