Basic Information
| Provider Information | |||||||||
| NPI: | 1184663296 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | ALLEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40480 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366400480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514343475 | ||||||||
| FaxNumber: | 2514343837 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 CENTER ST. | ||||||||
| Address2: | 2N | ||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514343475 | ||||||||
| FaxNumber: | 2514343985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 07/06/2018 | ||||||||
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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 | 207Q00000X | 15786 | AL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 51087275 | 01 | AL | BLUE CROSS | OTHER | 000087275 | 05 | AL | MEDICAID | 00121801 | 05 | MS | MEDICAID | 01-11635 | 01 | AL | UNITED HEALTH CARE | OTHER | 1410357 | 05 | LA | MEDICAID | 255968400 | 05 | FL | MEDICAID |