MEDICARE: JOHN GRAMLING ADAMS JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	103971	MO
2	2086S0129X	Vascular Surgery Physician	103971	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1980317	OTHER	MO	UNITED HEALTHCARE
2	G02433	OTHER	MO	MERCY
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	431428562	OTHER	MO	GREAT WEST
5	5410082	OTHER	MO	AETNA
6	28058	OTHER	MO	GHP
7	19973	OTHER	MO	HEALTHCARE USA
8	273734	OTHER	MO	HEALTHLINK, INC
9	20157	OTHER	MO	ANTHEM BLUECROSS BLUESHIE
10	9134342	OTHER	MO	PHCS

General Provider Information

NPI Number	:	1710981444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN GRAMLING ADAMS JR. M.D.

Provider Business Mailing Address
First Line	:	3220 BLUFF CREEK DR
Second Line	:	SUITE 100
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3663
Country	:	US
Telephone Number	:	573-443-8773
Fax Number	:	573-443-6843

Provider Business Practice Location Address
First Line	:	3220 BLUFF CREEK DR
Second Line	:	STE 100
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3663
Country	:	US
Telephone Number	:	573-443-8773
Fax Number	:	573-443-6843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/22/2022

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