Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063462778 Individual Practitioner Male Practitioner

Dr. Adam L Hickenbotham , OD

Optometrist • Provo, UT

Professional Overview & Biography Verified Profile Summary

Dr. Adam Hickenbotham, OD is a registered healthcare professional specializing in Optometrist in Provo, UT. Practice services are available at 122 E 1700 S BLDG 3 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

122 E 1700 S Bldg 3

Provo, UT 846065644

Telephone 3852485550
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Provo, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.4 Yrs
State Avg: 19.7 Yrs
Regional Practice Density
25 Specialists

Practicing in Provo, UT (484 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-12-03
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License UT 11993238-9934

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. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Optometrist

NUCC Taxonomy Code: 152W00000X

State License KY 2028DT

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. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Optometrist

NUCC Taxonomy Code: 152W00000X

State License CA OPT 12423 TPA

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. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Secondary Practice Locations

970 S Emery St

Slc, UT 841042050

Phone: 3852485550

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1356032205

Doctor of Optometry

Dr. William Cluff , OD

Optometrist - Corneal and Contact Management

NPI 1922536085

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location December 03, 2024

Registered at 122 E 1700 S BLDG 3, PROVO, UT 846065644 (Tel: 3852485550)

NPI Profile Active October 12, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 12, 2016

Registered at 147 SYCAMORE ST, PIKEVILLE, KY 415019118 (Tel: 6062185522)

📍
Updated Business Mailing Address October 12, 2016

Registered at 147 SYCAMORE ST, PIKEVILLE, KY 415019118 (Tel: 6062185522)

👤
Provider Name / Credentials Updated October 12, 2016

Recorded as ADAM HICKENBOTHAM, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 12, 2016

Optometrist (License #2028DT in KY)

🟢
Initial NPI Registration & Enumeration May 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063462778
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 11, 2006
Last Update: December 03, 2024
Sole Proprietor: Yes

Mailing Address

147 Sycamore St

Pikeville, KY 415019118

Phone: 6062185522

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.