Healthcare Provider Details

I. General information

NPI: 1346269958
Provider Name (Legal Business Name): JEFFREY W PERKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3519 FRIENDSVILLE RD
WOOSTER OH
44691-1241
US

IV. Provider business mailing address

3519 FRIENDSVILLE RD
WOOSTER OH
44691-1241
US

V. Phone/Fax

Practice location:
  • Phone: 330-345-7200
  • Fax: 330-345-8029
Mailing address:
  • Phone: 330-345-7200
  • Fax: 330-345-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.071623
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: