Provider Demographics
NPI:1073545034
Name:ADKINS, JAMES WILLIAMS (MDPAFACS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAMS
Last Name:ADKINS
Suffix:
Gender:M
Credentials:MDPAFACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 CHESTNUT CT E
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-2114
Mailing Address - Country:US
Mailing Address - Phone:727-785-8877
Mailing Address - Fax:727-934-1773
Practice Address - Street 1:1621 CHESTNUT CT E
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2114
Practice Address - Country:US
Practice Address - Phone:727-785-8877
Practice Address - Fax:727-934-1773
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME032360207Y00000X
FLME0032360207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL173840OtherWELLCARE, STAYWELL HEALTHCASE
FL000890500Medicaid
FL173840OtherWELLCARE, HEALTH EASE,
FL215113OtherAMERIGRD
FLD55862Medicare UPIN
FL50847Medicare PIN
FL173840OtherWELLCARE, STAYWELL HEALTHCASE