Provider Demographics
NPI:1912445438
Name:PERKINS, TERRY JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:JONATHAN
Last Name:PERKINS
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 1:2323 DE LA VINA ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3878
Mailing Address - Country:US
Mailing Address - Phone:805-563-0000
Mailing Address - Fax:805-563-9746
Practice Address - Street 1:2323 DE LA VINA ST STE 101
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3878
Practice Address - Country:US
Practice Address - Phone:805-563-0000
Practice Address - Fax:805-563-9746
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG030406207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck