Provider Demographics
NPI:1063440501
Name:PERKINS, KAREN ELIZABETH
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 PETERS CREEK RD NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24017-2500
Mailing Address - Country:US
Mailing Address - Phone:540-562-5700
Mailing Address - Fax:540-562-4278
Practice Address - Street 1:1314 PETERS CREEK RD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-2500
Practice Address - Country:US
Practice Address - Phone:540-562-5700
Practice Address - Fax:540-562-4278
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063731207Q00000X
VA0101252599207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine