Provider Demographics
NPI:1295863702
Name:JOHN L ADAMS OD PC
Entity Type:Organization
Organization Name:JOHN L ADAMS OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-356-7263
Mailing Address - Street 1:6 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-1912
Mailing Address - Country:US
Mailing Address - Phone:978-356-7263
Mailing Address - Fax:978-356-5574
Practice Address - Street 1:6 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-1912
Practice Address - Country:US
Practice Address - Phone:978-356-7263
Practice Address - Fax:978-356-5574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0324510001Medicare PIN
MAT59355Medicare UPIN
MA0324510001Medicare NSC
MA212758Medicare PIN