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Adam Hickenbotham, OD — NPI 1063462778, Provo, UT | NPI Central

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NPI 1063462778

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Adam Hickenbotham, OD

NPI 1063462778 · Optometrist · Provo, UT

Provider details

NPI number: 1063462778
Entity type: Individual
Primary specialty: OptometristEye and Vision Services Providers
Credential: OD
Sex: Male
Sole proprietor: Yes
License: 2028DT (KY)

Practice location

122 E 1700 S Bldg 3

Provo, UT 84606-5644

Phone: (385) 248-5550

More UT providers

Mailing address

147 Sycamore St

Pikeville, KY 41501-9118

Registry dates

Enumerated: 2006-05-11
Last updated: 2024-12-03

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.