Provider Demographics
NPI:1831955525
Name:PERKINS, AUSTIN (HIS)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:
Last Name:PERKINS
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 LEMAY FERRY RD
Mailing Address - Street 2:SAM'S CLUB HEARING CENTER
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129
Mailing Address - Country:US
Mailing Address - Phone:314-892-2461
Mailing Address - Fax:
Practice Address - Street 1:4512 LEMAY FERRY RD
Practice Address - Street 2:SAM'S CLUB HEARING CENTER
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129
Practice Address - Country:US
Practice Address - Phone:314-892-2461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017008471237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist