Basic Information
| Provider Information | |||||||||
| NPI: | 1669400677 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADKINS | ||||||||
| FirstName: | TERRANCE | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 13627 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857323627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207507166 | ||||||||
| FaxNumber: | 5208861929 | ||||||||
| Practice Location | |||||||||
| Address1: | 1951 N WILMOT RD | ||||||||
| Address2: | BUILDING 2 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857128000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207955845 | ||||||||
| FaxNumber: | 5207958620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2006 | ||||||||
| LastUpdateDate: | 08/13/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 24013 | AZ | N | Allopathic & Osteopathic Physicians | Surgery | 208C00000X | 24013 | AZ | Y | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
ID Information
| ID | Type | State | Issuer | Description | 203604285 | 01 | AZ | UNITED | OTHER | 91783 | 01 | AZ | PACIFICARE | OTHER | 2Z3330 | 01 | AZ | HEALTH NET | OTHER | 340159-20 | 05 | AZ | MEDICAID | AZ0153640 | 01 | AZ | BCBS | OTHER |