Provider Demographics
NPI:1659425254
Name:PERKINSON, ROBERT RONALD (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RONALD
Last Name:PERKINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:RONALD
Other - Last Name:PERKINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:1010 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:SD
Mailing Address - Zip Code:57013-1905
Mailing Address - Country:US
Mailing Address - Phone:605-987-2872
Mailing Address - Fax:605-987-2365
Practice Address - Street 1:1010 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:SD
Practice Address - Zip Code:57013-1905
Practice Address - Country:US
Practice Address - Phone:605-987-2872
Practice Address - Fax:605-987-2365
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD269103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist