Basic Information
| Provider Information | |||||||||
| NPI: | 1790726016 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | BARRY | ||||||||
| MiddleName: | KEITH | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.A.-C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 260 FORT SANDERS WEST BLVD | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379223355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655584400 | ||||||||
| FaxNumber: | 8655584421 | ||||||||
| Practice Location | |||||||||
| Address1: | 260 FORT SANDERS WEST BLVD | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8657694500 | ||||||||
| FaxNumber: | 8654501214 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 08/10/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 137 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 3669611 | 05 | TN | MEDICAID | 009939596 | 05 | AL | MEDICAID | 165408089A | 05 | GA | MEDICAID | 6002362 | 01 | TN | BLUECROSS BLUESHIELD | OTHER | P01332495 | 01 | TN | RAILROAD MEDICARE | OTHER | 3711721 | 01 | TN | MEDICARE PTAN | OTHER | 4017592 | 01 | TN | BLUE CROSS | OTHER | 9139914 | 01 | TN | AETNA | OTHER | 970015623 | 01 | TN | RAILROAD MEDICARE | OTHER |