National Provider Identifier Database

ADAM L HICKENBOTHAM, OD – NPI #1063462778
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

ADAM L HICKENBOTHAM, OD
122 E 1700 S BLDG 3
PROVO, UT84606-5644
Phone: 385-248-5550
Fax:
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for ADAM L HICKENBOTHAM

NPI Number 1063462778
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 05/11/2006
Last updated 12/03/2024 - More than a year ago
Sole proprietor1 Yes
Identifiers
  • CA License #: OPT 12423 TPA
  • KY License #: 2028DT
  • UT License #: 11993238-9934
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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