Organization
ALAN ADAMSON, OD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN P ADAMSON O.D. (CEO)
(208) 552-3355
Entity
Organization
Contact information
Practice address
2300 E 17TH ST, SUITE 1157, IDAHO FALLS, ID 83404-6504
(208) 552-3355
(208) 552-6120
Mailing address
PO BOX 3187, IDAHO FALLS, ID 83403-3187
(208) 552-3355
(208) 552-6120
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-1028
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010144405
REGENCE BLUESHIELD
ID
05
—
807677100
—
ID
01
—
V4650
BLUE CROSS OF IDAHO
ID
Enumeration date
07/02/2008
Last updated
07/02/2008
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