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General NPI Number Information
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NPI Number | 1154637932
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Entity Type | Individual
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Provider Name | IAN PERKINS PA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 1911 K M WICKER MEMORIAL DR
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City | SANFORD
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State | NC
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Zip | 27330-5070
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Country | US
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Telephone | 919-439-9251
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 K M WICKER MEMORIAL DR
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City | SANFORD
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State | NC
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Zip | 27330-5070
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Country | US
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Telephone | 919-439-9251
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0868
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-08049
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License Number State | NC
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