Provider Demographics
NPI:1659305746
Name:ADKISSON, WILLIAM H JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:ADKISSON
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:1554 HERRINGTON HLS
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:KY
Mailing Address - Zip Code:40444-7266
Mailing Address - Country:US
Mailing Address - Phone:859-792-8118
Mailing Address - Fax:859-323-2412
Practice Address - Street 1:740 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5533
Practice Address - Fax:859-323-2412
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYPA 085363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical