Provider Demographics
NPI:1710929641
Name:PERKINS, JEFFREY D (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1715 IRON HORSE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-9617
Mailing Address - Country:US
Mailing Address - Phone:720-494-4700
Mailing Address - Fax:720-494-4706
Practice Address - Street 1:1715 IRON HORSE DR STE 100
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-9617
Practice Address - Country:US
Practice Address - Phone:720-494-4700
Practice Address - Fax:720-494-4706
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO34988207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01349885Medicaid
CO22994Medicaid
CO22994Medicaid
G46547Medicare UPIN