MEDICARE: MICHAEL G ADKISON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME97111	FL
2	207L00000X	Anesthesiology Physician	ME97111	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1104903160	OTHER	FL	GROUP NPI NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942248166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL G ADKISON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3012
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32085-3012
Country	:	US
Telephone Number	:	866-480-2246
Fax Number	:	770-237-1124

Provider Business Practice Location Address
First Line	:	300 HEALTH PARK BLVD
Second Line	:	SUITE 5008
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-3707
Country	:	US
Telephone Number	:	904-810-0686
Fax Number	:	770-237-1124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	01/03/2024

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