Basic Information
Provider Information
NPI: 1003002502
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADKINS
FirstName: CAROL
MiddleName: G
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3026 HIDDEN LAKE PT
Address2:  
City: OWENSBORO
State: KY
PostalCode: 423034455
CountryCode: US
TelephoneNumber: 2706859499
FaxNumber: 2706859443
Practice Location
Address1: 1605 SCHERM RD
Address2:  
City: OWENSBORO
State: KY
PostalCode: 423015300
CountryCode: US
TelephoneNumber: 2706636050
FaxNumber: 2706636051
Other Information
ProviderEnumerationDate: 09/18/2007
LastUpdateDate: 03/03/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X001291KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
00000053446801KYBLUE CROSS BLUE SHIELDOTHER


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