Basic Information
| Provider Information | |||||||||
| NPI: | 1215048582 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHN V ADAMS MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 119 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421342752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705869533 | ||||||||
| FaxNumber: | 2705860123 | ||||||||
| Practice Location | |||||||||
| Address1: | 119 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421342752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705869533 | ||||||||
| FaxNumber: | 2705860123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 06/14/2016 | ||||||||
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| AuthorizedOfficialLastName: | ADAMS | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2705869533 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | II | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
ID Information
| ID | Type | State | Issuer | Description | 7100010260 | 05 | KY | MEDICAID |