Provider Demographics
NPI:1851824676
Name:PERKINS, BRYCE DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:DANIEL
Last Name:PERKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 ROSE ST STE CC-402
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-1786
Mailing Address - Fax:859-257-7715
Practice Address - Street 1:800 ROSE ST STE CC-402
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-323-1786
Practice Address - Fax:859-257-7715
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR2773207R00000X
KYTP199207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine