Provider Demographics
NPI:1700956182
Name:PERINI, CORINNE (OD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:PERINI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-6203
Mailing Address - Country:US
Mailing Address - Phone:918-599-0202
Mailing Address - Fax:918-599-0279
Practice Address - Street 1:1619 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-6203
Practice Address - Country:US
Practice Address - Phone:918-599-0202
Practice Address - Fax:918-599-0279
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2468152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist