Provider Demographics
NPI:1790577088
Name:ADKINS, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ADKINS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1483 OLDAKER RD
Mailing Address - Street 2:
Mailing Address - City:LEON
Mailing Address - State:WV
Mailing Address - Zip Code:25123-6786
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1483 OLDAKER RD
Practice Address - Street 2:
Practice Address - City:LEON
Practice Address - State:WV
Practice Address - Zip Code:25123-6786
Practice Address - Country:US
Practice Address - Phone:305-634-9206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide