Provider Demographics
NPI:1790726016
Name:PERKINS, BARRY KEITH (PA-C)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:KEITH
Last Name:PERKINS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 FORT SANDERS WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3355
Mailing Address - Country:US
Mailing Address - Phone:865-558-4400
Mailing Address - Fax:865-558-4421
Practice Address - Street 1:260 FORT SANDERS WEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-769-4500
Practice Address - Fax:865-450-1214
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN137363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3669611Medicaid
AL009939596Medicaid
GA165408089AMedicaid
TN6002362OtherBLUECROSS BLUESHIELD
TNP01332495OtherRAILROAD MEDICARE
TN3711721OtherMEDICARE PTAN
TN4017592OtherBLUE CROSS
TN9139914OtherAETNA
TN970015623OtherRAILROAD MEDICARE
GA165408089AMedicaid
TN3669619Medicare PIN
TNP01332495OtherRAILROAD MEDICARE
TN103I972974Medicare PIN