Provider Demographics
NPI:1659510626
Name:PERKINS, SHARON GROVE (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:GROVE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MONT VERNON RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4123
Mailing Address - Country:US
Mailing Address - Phone:603-673-1330
Mailing Address - Fax:
Practice Address - Street 1:81 MONT VERNON RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4123
Practice Address - Country:US
Practice Address - Phone:603-673-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0661152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80587889Medicaid
NHU22368Medicare UPIN