Basic Information
Provider Information
NPI: 1003140989
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAIR
FirstName: JAMES
MiddleName: RANSOM
NamePrefix: MR.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2425 REGENCY RD
Address2: SUITE A
City: LEXINGTON
State: KY
PostalCode: 405032948
CountryCode: US
TelephoneNumber: 8592778179
FaxNumber: 8592779320
Practice Location
Address1: 1740 NICHOLASVILLE RD
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405031431
CountryCode: US
TelephoneNumber: 8592778179
FaxNumber: 8592779320
Other Information
ProviderEnumerationDate: 09/25/2009
LastUpdateDate: 09/25/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA444KYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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