Provider Demographics
NPI:1477658458
Name:PERKINS, THOMAS R (DO, FAOAO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:PERKINS
Suffix:
Gender:M
Credentials:DO, FAOAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 S ROCHESTER RD STE 205
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3152
Mailing Address - Country:US
Mailing Address - Phone:248-239-5300
Mailing Address - Fax:248-239-5305
Practice Address - Street 1:1349 S ROCHESTER RD STE 205
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3152
Practice Address - Country:US
Practice Address - Phone:248-239-5300
Practice Address - Fax:248-239-5305
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012657207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH16462Medicare UPIN
MI0N31330Medicare ID - Type Unspecified
MI6186130001Medicare NSC