Provider Demographics
NPI:1851396782
Name:PERKINS, JANET LEE (OD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LEE
Other - Last Name:SCHONHOFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:346 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-3407
Mailing Address - Country:US
Mailing Address - Phone:336-835-1312
Mailing Address - Fax:336-835-9911
Practice Address - Street 1:346 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-3407
Practice Address - Country:US
Practice Address - Phone:336-835-1312
Practice Address - Fax:336-835-9911
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1001152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909813Medicaid
NC246319AMedicare ID - Type Unspecified
NC8909813Medicaid