Provider Demographics
NPI:1275984908
Name:URBANSKI, ADAM (OD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:URBANSKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E FRONT ST
Mailing Address - Street 2:STE A
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107-1403
Mailing Address - Country:US
Mailing Address - Phone:269-695-3434
Mailing Address - Fax:
Practice Address - Street 1:400 E FRONT ST
Practice Address - Street 2:STE A
Practice Address - City:BUCHANAN
Practice Address - State:MI
Practice Address - Zip Code:49107-1403
Practice Address - Country:US
Practice Address - Phone:269-695-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004983152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist