1083035000 NPI number — HENRY G. ADKINS, M. D., P. S. C.

Table of content: (NPI 1083035000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083035000 NPI number — HENRY G. ADKINS, M. D., P. S. C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENRY G. ADKINS, M. D., P. S. C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083035000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 517
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAYSON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41143-0517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-474-7808
Provider Business Mailing Address Fax Number:
606-474-4654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 STATE HIGHWAY 1947
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
GRAYSON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41143-6825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-474-7808
Provider Business Practice Location Address Fax Number:
606-474-4654
Provider Enumeration Date:
12/17/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADKINS
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
606-474-7808

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  26646 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)