MEDICARE: DR. FRANKLIN TERRY PERKINS III M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	64151	AZ

General Provider Information

NPI Number	:	1174057830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANKLIN TERRY PERKINS III M.D.

Provider Business Mailing Address
First Line	:	1921 AUTUMN DR
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76262-4922
Country	:	US
Telephone Number	:	817-223-0616
Fax Number	:

Provider Business Practice Location Address
First Line	:	3533 CANYON DE FLORES STE A
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85650-5366
Country	:	US
Telephone Number	:	520-685-3336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2017
Last Update Date	:	09/10/2021

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