Provider Demographics
NPI:1710981444
Name:ADAMS, JOHN GRAMLING JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:GRAMLING
Last Name:ADAMS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3220 BLUFF CREEK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-3663
Mailing Address - Country:US
Mailing Address - Phone:573-443-8773
Mailing Address - Fax:573-443-6843
Practice Address - Street 1:3220 BLUFF CREEK DR
Practice Address - Street 2:STE 100
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-3663
Practice Address - Country:US
Practice Address - Phone:573-443-8773
Practice Address - Fax:573-443-6843
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2022-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO103971208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1980317OtherUNITED HEALTHCARE
MOG02433OtherMERCY
MO207974908Medicaid
MO431428562OtherGREAT WEST
MO5410082OtherAETNA
MO28058OtherGHP
MO19973OtherHEALTHCARE USA
MO273734OtherHEALTHLINK, INC
MO20157OtherANTHEM BLUECROSS BLUESHIE
MO9134342OtherPHCS
MO19973OtherHEALTHCARE USA
MOG02433Medicare UPIN
MO1980317OtherUNITED HEALTHCARE