Search › Utah › 152W00000X
Adam Hickenbotham, OD
NPI 1063462778 · on the registry since 2006 · sole proprietor
Practice
- Address
- 122 E 1700 S Bldg 3
Provo, UT 84606 - Phone
- (385) 248-5550
- Organisation at this address
- Rocky Mountain University Of Health Professions Foundation
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 10
Additional practice sites
- 970 S Emery St, Slc, UT
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152W00000X
152W00000X - Licence states on file
- KY, UT, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-12-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah