Provider Demographics
NPI:1154359438
Name:PERKINS, WILLIAM J (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 504714
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-4714
Mailing Address - Country:US
Mailing Address - Phone:888-991-1101
Mailing Address - Fax:903-787-5854
Practice Address - Street 1:3301 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-5627
Practice Address - Country:US
Practice Address - Phone:888-991-1101
Practice Address - Fax:903-787-5854
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11975207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK671972OtherFIRSTHEALTH
OK352490000OtherDEPT OF LABOR
OK100228430CMedicaid
OK4348620OtherAETNA
OK163991OtherFIRSTHEALTH MAIL HANDLERS
OK671972OtherFIRSTHEALTH
OK100228430CMedicaid
P00089454Medicare PIN