Healthcare Provider Details

I. General information

NPI: 1760585954
Provider Name (Legal Business Name): JOHN TODD PERKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 THOMAS MORE PKWY
CRESTVIEW HILLS KY
41017-3410
US

IV. Provider business mailing address

4805 MONTGOMERY RD SUITE 150
CINCINNATI OH
45212-2198
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-4266
  • Fax: 859-341-9532
Mailing address:
  • Phone: 513-961-5558
  • Fax: 513-961-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35-058246
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number35.058246
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number26023
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number26023
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: