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General NPI Number Information
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NPI Number | 1740476233
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Entity Type | Organization
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Legal Business Name | BRIAN PATRICK ADAIR OD PLLC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 475 HILLCREST AVE
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City | AMERICAN FALLS
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State | ID
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Zip | 83211-1323
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Country | US
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Telephone | 208-226-2333
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Fax | 208-226-2785
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Provider Business Mailing Address
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Address Line | 475 HILLCREST AVE
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City | AMERICAN FALLS
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State | ID
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Zip | 83211-1323
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Country | US
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Telephone | 208-226-2333
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Fax | 208-226-2785
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. BRIAN PATRICK ADAIR
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Credential | O.D.
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Telephone | 208-226-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | ODP-100147
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License Number State | ID
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