Provider Demographics
NPI:1285736595
Name:ADAMS, JOHN V II (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:V
Last Name:ADAMS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1759
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
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36169207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64026545Medicaid
KY64026545Medicaid
KY000000187736OtherBLUE CROSS NUMBER
KYG66914Medicare UPIN