Provider Demographics
NPI:1457444200
Name:ADLER, WILLIAM RAE (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RAE
Last Name:ADLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:6584 165TH STREET
Mailing Address - City:ALBIA
Mailing Address - State:IA
Mailing Address - Zip Code:52531-0100
Mailing Address - Country:US
Mailing Address - Phone:641-932-7614
Mailing Address - Fax:641-932-3372
Practice Address - Street 1:6584 165TH ST
Practice Address - Street 2:BOX 100
Practice Address - City:ALBIA
Practice Address - State:IA
Practice Address - Zip Code:52531-0100
Practice Address - Country:US
Practice Address - Phone:641-932-7614
Practice Address - Fax:641-932-3372
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA1561152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0091058Medicaid
IA09105Medicare ID - Type Unspecified
IA0357130001Medicare NSC
IA0091058Medicaid