Individual
JONATHAN ROSS ADKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
971 LAKELAND DRIVE, SUITE 1460, JACKSON, MS 39216-4684
(601) 982-3202
(601) 982-3259
Mailing address
971 LAKELAND DRIVE, SUITE 1460, JACKSON, MS 39216-4684
(601) 982-3202
(601) 982-3259
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19862
MS
208600000X
Surgery Physician
M3841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06902563
—
MS
01
—
5121020010
MEDICARE PTAN
—
Enumeration date
09/26/2006
Last updated
08/24/2011
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