Provider Demographics
NPI:1467963868
Name:PERKINS, LAURA MARTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARTIN
Last Name:PERKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 672
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:LA
Mailing Address - Zip Code:71263-0672
Mailing Address - Country:US
Mailing Address - Phone:318-669-0901
Mailing Address - Fax:318-490-8004
Practice Address - Street 1:803 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:LA
Practice Address - Zip Code:71263-2534
Practice Address - Country:US
Practice Address - Phone:318-428-4344
Practice Address - Fax:318-490-8004
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist