Provider Demographics
NPI:1366479024
Name:ADAMS, TERRE WILSON (MD)
Entity Type:Individual
Prefix:
First Name:TERRE
Middle Name:WILSON
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2518
Mailing Address - Country:US
Mailing Address - Phone:859-278-5926
Mailing Address - Fax:
Practice Address - Street 1:2101 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2518
Practice Address - Country:US
Practice Address - Phone:859-278-5926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26898207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4000501OtherMEDICARE LAB GRP
KY0169OtherMEDICARE GROUP NUMBER
KY0091190OtherMEDICARE PTAN
KYCB5773OtherRR MEDICARE GRP
KY110165587OtherRR MEDICARE PIN
KY64268980Medicaid
KY37903705OtherMEDICAID LAB GRP
KY64268980Medicaid
E39202Medicare UPIN