Provider Demographics
NPI:1124013263
Name:PERKINS, ORRIN W (MD)
Entity Type:Individual
Prefix:
First Name:ORRIN
Middle Name:W
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 1:7340 SHADELAND STATION
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3980
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:7340 SHADELAND STATION
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3980
Practice Address - Country:US
Practice Address - Phone:317-579-2150
Practice Address - Fax:317-579-2130
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10415422085R0202X
IN01041542A2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000109957OtherANTHEM
INP00023637OtherRR MEDICARE PINS
INP00024408OtherRR MEDICARE PINS
IN300059734OtherRAILROAD MEDICARE
INP00024034OtherRR MEDICARE PINS
INP00023636OtherRR MEDICARE PINS
INP00024076OtherRR MEDICARE PINS
INP00024084OtherRR MEDICARE PINS
INP00024409OtherRR MEDICARE PINS
IN100320730AMedicaid
INP00024095OtherRR MEDICARE PINS
INP00024403OtherRR MEDICARE PINS
INP00024404OtherRR MEDICARE PINS
INP00024389OtherRR MEDICARE PINS
INP00014389OtherRR MEDICARE PINS
INP00024046OtherRR MEDICARE PINS
INP00034084OtherRR MEDICARE PINS
IN151560XMedicare PIN
INP00024409OtherRR MEDICARE PINS
INP00024404OtherRR MEDICARE PINS
IN300059734OtherRAILROAD MEDICARE