Provider Demographics
NPI:1861662744
Name:PERKINS, CHAD A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:A
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 1:900 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-2844
Mailing Address - Country:US
Mailing Address - Phone:918-552-5546
Mailing Address - Fax:918-552-5543
Practice Address - Street 1:900 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-2844
Practice Address - Country:US
Practice Address - Phone:918-552-5546
Practice Address - Fax:918-552-5543
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1948363A00000X, 363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant