Provider Demographics
NPI:1881096337
Name:ADKINS, JIMMY II (PA-C)
Entity type:Individual
Prefix:
First Name:JIMMY
Middle Name:
Last Name:ADKINS
Suffix:II
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HENSLEY HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:MAN
Mailing Address - State:WV
Mailing Address - Zip Code:25635-1402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:174 CENTER ST
Practice Address - Street 2:
Practice Address - City:STOLLINGS
Practice Address - State:WV
Practice Address - Zip Code:25646
Practice Address - Country:US
Practice Address - Phone:304-792-7130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant