Provider Demographics
NPI:1962519124
Name:PERKINS, AARON W JR (DPM)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:W
Last Name:PERKINS
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1303 SUNSET DRIVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604
Mailing Address - Country:US
Mailing Address - Phone:423-232-1771
Mailing Address - Fax:423-929-0328
Practice Address - Street 1:1303 SUNSET DRIVE
Practice Address - Street 2:SUITE 6
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-232-1771
Practice Address - Fax:423-929-0328
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDPM000510213E00000X
NC391213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3352746Medicaid
TN3352746Medicaid
TN7034160001Medicare NSC
U66624Medicare UPIN