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General NPI Number Information
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NPI Number | 1073595153
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Entity Type | Individual
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Provider Name | CAMILLE PERKINS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 326 N HOOD ST
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City | LAKE PROVIDENCE
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State | LA
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Zip | 71254-2140
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Country | US
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Telephone | 318-559-4900
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Fax | 318-559-1772
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Provider Business Mailing Address
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Address Line | 326 N HOOD ST
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City | LAKE PROVIDENCE
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State | LA
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Zip | 71254-2140
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Country | US
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Telephone | 318-559-4900
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Fax | 318-559-1772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 109044R
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License Number State | LA
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