Basic Information
| Provider Information | |||||||||
| NPI: | 1881623270 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | KRISTI | ||||||||
| MiddleName: | CAUDILL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 S BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405042701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592584138 | ||||||||
| FaxNumber: | 8592584796 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 ROSE ST # MS 119 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405362701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592571446 | ||||||||
| FaxNumber: | 8592577572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 02/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZC0500X | 31999 | KY | N | Allopathic & Osteopathic Physicians | Pathology | Cytopathology | 207ZH0000X | 31999 | KY | N | Allopathic & Osteopathic Physicians | Pathology | Hematology | 207ZP0102X | 31999 | KY | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZB0001X | 31999 | KY | Y | Allopathic & Osteopathic Physicians | Pathology | Blood Banking & Transfusion Medicine |
ID Information
| ID | Type | State | Issuer | Description | 220030412 | 01 | KY | RR MEDICARE PIN | OTHER | 37903705 | 01 | KY | MEDICAID LAB GROUP | OTHER | 64031180 | 05 | KY | MEDICAID | 4000501 | 01 | KY | MEDICARE LAB GRP | OTHER | CB5773 | 01 | KY | RR MEDICARE GROUP | OTHER |