Basic Information
| Provider Information | |||||||||
| NPI: | 1881799310 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEINGOLD | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | FORD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863011601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287768428 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1005 DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863011601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287768428 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 09/05/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 23246 | AZ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 160044283 | 01 | AZ | RAIL ROAD MEDICARE | OTHER | AZ0833200 | 01 | AZ | BCBS | OTHER | 315673 | 05 | AZ | MEDICAID | AZ2502 | 01 | AZ | HEALTHNET | OTHER |