Provider Demographics
NPI:1699801316
Name:PERKINS, RICK L (MD)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:L
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:ASPIRUS CREDENTIALING
Mailing Address - Street 2:P.O. BOX 8004
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54402
Mailing Address - Country:US
Mailing Address - Phone:715-847-2000
Mailing Address - Fax:
Practice Address - Street 1:ASPIRUS GENERAL CLINIC
Practice Address - Street 2:110 EAST 5TH AVENUE
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409
Practice Address - Country:US
Practice Address - Phone:715-623-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33903207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33903OtherSTATE LICENSE
WI31887200Medicaid
WI31887200Medicaid
WI33903OtherSTATE LICENSE
WI31887200Medicaid