Provider Demographics
NPI:1386789428
Name:PERKINS, GREGORY MEREDITH (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MEREDITH
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5528 HENNESSEY CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1771
Mailing Address - Country:US
Mailing Address - Phone:314-647-5885
Mailing Address - Fax:
Practice Address - Street 1:1100 W STEWART DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3849
Practice Address - Country:US
Practice Address - Phone:714-633-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98883207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology