Basic Information
| Provider Information | |||||||||
| NPI: | 1396014486 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALO | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2807 N MAIN ST | ||||||||
| Address2: | PO BOX 1299 | ||||||||
| City: | TARBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278861903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528238295 | ||||||||
| FaxNumber: | 2528238552 | ||||||||
| Practice Location | |||||||||
| Address1: | 2807 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | TARBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278861903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528238295 | ||||||||
| FaxNumber: | 2528238552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2011 | ||||||||
| LastUpdateDate: | 03/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2243 | NC | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.