Provider Demographics
NPI:1700897691
Name:PERKEL, JOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:PERKEL
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 1:5400 BOWMAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-8879
Mailing Address - Country:US
Mailing Address - Phone:478-745-6576
Mailing Address - Fax:478-746-0018
Practice Address - Street 1:5400 BOWMAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-8879
Practice Address - Country:US
Practice Address - Phone:478-745-6576
Practice Address - Fax:478-746-0018
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056343208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA922893588AMedicaid
GA58134766OtherTAX ID NUMBER
GA58134766OtherTAX ID NUMBER
GA34BDDMMMedicare ID - Type Unspecified