Individual
KEVIN ADKISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 E MAIN ST, TISHOMINGO, OK 73460-2339
(580) 257-0474
(580) 371-9944
Mailing address
201 E MAIN ST, TISHOMINGO, OK 73460-0201
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
OK
Enumeration date
05/14/2014
Last updated
05/14/2014
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