MEDICARE: ALAN ADAMS PA-C

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	363A00000X	Physician Assistant	PA-1232	ID

General Provider Information

NPI Number	:	1891188348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN ADAMS PA-C

Provider Business Mailing Address
First Line	:	3820 CRESTWOOD LN
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4979
Country	:	US
Telephone Number	:	208-552-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 CRESTWOOD LN
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4979
Country	:	US
Telephone Number	:	208-552-7700
Fax Number	:

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

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	11/03/2020

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Directions to “ ALAN ADAMS PA-C” Practice Location

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