Provider Demographics
NPI:1821006313
Name:PERKINS, THOMAS F (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1778
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-1778
Mailing Address - Country:US
Mailing Address - Phone:931-222-4213
Mailing Address - Fax:931-222-4182
Practice Address - Street 1:501 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3510
Practice Address - Country:US
Practice Address - Phone:931-222-4213
Practice Address - Fax:931-222-4182
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45797208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF03865Medicare UPIN
AK8ED351Medicare PIN
AKMD6402Medicaid