Provider Demographics
NPI:1942242300
Name:ADAMS EYE CARE, PC
Entity Type:Organization
Organization Name:ADAMS EYE CARE, PC
Other - Org Name:ADAMS EYE CARE, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JUANAKEE
Authorized Official - Middle Name:RAEDELL
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-323-4608
Mailing Address - Street 1:1712 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-2023
Mailing Address - Country:US
Mailing Address - Phone:205-323-4608
Mailing Address - Fax:205-252-0203
Practice Address - Street 1:1712 5TH AVE N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-2023
Practice Address - Country:US
Practice Address - Phone:205-323-4608
Practice Address - Fax:205-252-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-444-TA-297152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000810517Medicaid
AL000059682Medicare ID - Type Unspecified
AL000810517Medicaid