Provider Demographics
NPI:1164538229
Name:ADKISON, RODNEY K (DO)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:K
Last Name:ADKISON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1125 MADISON ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-5227
Practice Address - Country:US
Practice Address - Phone:573-632-5000
Practice Address - Fax:573-634-2033
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5N94207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10296C001OtherBC/BS
MO243613718Medicaid
MO04-00806OtherUNITED HEALTHCARE
MO21938OtherBLUE CHOICE
MO4466283OtherAETNA
MO13051OtherGROUP HEALTH PLAN
MO010047232OtherRR MEDICARE
MO105935OtherMERCY HEALTH CARE INS.
MO298950OtherHEALTHLINK
MO04-00806OtherUNITED HEALTHCARE
MOE96313Medicare UPIN