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NPI Code Detail

MEDICARE: STUART ADAMS OD PC

MEDICARE: STUART ADAMS OD PC
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
1152W00000XOptometristOPT9189CA

General Provider Information

NPI Number : 1821367236
Entity Type Code : Organization
Provider Name (Legal Business Name) : STUART ADAMS OD PC
Provider Business Mailing Address
First Line : 110 N SPRING ST
Second Line :
City : BLYTHE
State : CA
Zip : 92225-1633
Country : US
Telephone Number : 760-922-3951
Fax Number : 760-922-5202
Provider Business Practice Location Address
First Line : 110 N SPRING ST
Second Line :
City : BLYTHE
State : CA
Zip : 92225-1633
Country : US
Telephone Number : 760-922-3951
Fax Number : 760-922-5202
Authorized Official
Title or Position : OPTOMETRIST/OWNER
Name : STUART B ADAMS
Credential : O.D.
Telephone Number : 928-680-1144
Provider Enumeration Date : 12/14/2011
Last Update Date : 05/31/2012

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Directions to “STUART ADAMS OD PC ” Practice Location

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