Provider Demographics
NPI:1285628578
Name:ADKINS, DONNIE L (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONNIE
Middle Name:L
Last Name:ADKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 DANIEL DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2527
Mailing Address - Country:US
Mailing Address - Phone:859-236-1810
Mailing Address - Fax:859-236-1802
Practice Address - Street 1:129 DANIEL DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2527
Practice Address - Country:US
Practice Address - Phone:859-236-1810
Practice Address - Fax:859-236-1802
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8077122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100040970Medicaid