Provider Demographics
NPI:1215048582
Name:JOHN V ADAMS MD
Entity type:Organization
Organization Name:JOHN V ADAMS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:V
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:270-586-9533
Mailing Address - Street 1:119 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134-2752
Mailing Address - Country:US
Mailing Address - Phone:270-586-9533
Mailing Address - Fax:270-586-0123
Practice Address - Street 1:119 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-2752
Practice Address - Country:US
Practice Address - Phone:270-586-9533
Practice Address - Fax:270-586-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100010260Medicaid
KY9300Medicare ID - Type UnspecifiedMEDICARE GROUP NO