Provider Demographics
NPI:1457589079
Name:MAYS-KINGSTON, ADRIENNE M (MD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:M
Last Name:MAYS-KINGSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:MARIE
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE STE 1500
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1562
Mailing Address - Country:US
Mailing Address - Phone:740-446-5000
Mailing Address - Fax:740-446-5486
Practice Address - Street 1:100 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:855-446-5937
Practice Address - Fax:740-446-5486
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV35.143937207Q00000X
OH35.143937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100215520Medicaid
OH0069101Medicaid
WV3810023724Medicaid