1821056052 NPI number — DR. WILLIAM C ADAMS O.D.

Table of content: DR. WILLIAM C ADAMS O.D. (NPI 1821056052)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821056052 NPI number — DR. WILLIAM C ADAMS O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAMS
Provider First Name:
WILLIAM
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADAMS
Provider Other First Name:
W.C.
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1821056052
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 397
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENSON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27504-0397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-894-2001
Provider Business Mailing Address Fax Number:
919-894-3190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27504-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-894-2001
Provider Business Practice Location Address Fax Number:
919-894-3190
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  770 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8909010 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0901O . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com