Provider Demographics
NPI:1386662708
Name:ADKINS, SAMUEL III (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:ADKINS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MEDICAL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5197
Mailing Address - Country:US
Mailing Address - Phone:828-437-4211
Mailing Address - Fax:828-438-4109
Practice Address - Street 1:103 MEDICAL HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5197
Practice Address - Country:US
Practice Address - Phone:828-437-4211
Practice Address - Fax:828-438-4109
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6249207Q00000X
NC28935207Q00000X, 207QS0010X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC2216Medicaid
NC1386662708Medicaid
NC891327MMedicaid
NC1386662708Medicaid
NC891327MMedicaid
NCNC9182AMedicare PIN
NC2228765GMedicare PIN