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General NPI Number Information
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NPI Number | 1447328497
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Entity Type | Organization
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Legal Business Name | STUART ADAMS O.D. PC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 383 S.LAKE HAVASU AVE
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-9368
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Country | US
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Telephone | 928-680-1144
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Fax | 928-680-8639
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Provider Business Mailing Address
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Address Line | 383 LAKE HAVASU AVE S
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-9368
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Country | US
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Telephone | 928-680-1144
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Fax | 928-680-8639
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Authorized Official
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Title or Position | OWNER
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Name | STUART ADAMS
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Credential | O.D.PC
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Telephone | 928-680-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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