Basic Information
Provider Information | |||||||||
NPI: | 1871589507 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | PERKINS | ||||||||
FirstName: | RICHARD | ||||||||
MiddleName: | A | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 500 S UNIVERSITY AVE STE 500 | ||||||||
Address2: |   | ||||||||
City: | LITTLE ROCK | ||||||||
State: | AR | ||||||||
PostalCode: | 722055307 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5016644532 | ||||||||
FaxNumber: | 5016634335 | ||||||||
Practice Location | |||||||||
Address1: | 2 SAINT VINCENT CIR | ||||||||
Address2: |   | ||||||||
City: | LITTLE ROCK | ||||||||
State: | AR | ||||||||
PostalCode: | 722055423 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5016644532 | ||||||||
FaxNumber: | 5016634335 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/27/2005 | ||||||||
LastUpdateDate: | 03/18/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 03/18/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | E-1568 | AR | N |   | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | E-1568 | AR | Y |   | Allopathic & Osteopathic Physicians | Anesthesiology |   |
ID Information
ID | Type | State | Issuer | Description | 17971000020 | 01 | AR | QUAL CHOICE (LRPM) | OTHER | 050060653 | 01 | AR | RAILROAD MEDICARE | OTHER | 71033532430 | 01 | AR | QUAL CHOICE | OTHER | 050060628 | 01 | AR | RAILROAD MEDICARE (LRPM) | OTHER | 171973300 | 01 | AR | US DEPT. OF LABOR OWCP | OTHER | 134517001 | 05 | AR |   | MEDICAID | 5K811 | 01 | AR | BLUE CROSS BLUE SHIELD | OTHER | 770132201 | 01 | AR | ARKANSAS BREASTCARE | OTHER | S03446 | 01 | AR | NOVASYS | OTHER |