Provider Demographics
NPI:1295709665
Name:ADAN, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ADAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JAROSLAV
Other - Middle Name:M
Other - Last Name:ZDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8275 S OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:MOHAVE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86440-9216
Mailing Address - Country:US
Mailing Address - Phone:903-571-2176
Mailing Address - Fax:888-503-3778
Practice Address - Street 1:8275 S OLIVE AVE
Practice Address - Street 2:
Practice Address - City:MOHAVE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86440-9216
Practice Address - Country:US
Practice Address - Phone:903-571-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD 31743207RI0011X
ND9865207RI0011X
NMMD2004-0681207RI0011X
WAMD 60540307207RI0011X
NV5498207RI0011X
CAA44024207RI0011X
AZ17530207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology