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Individual

DR. KENNETH LEON PERKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
5407 HIXSON PIKE, SUITE 121, HIXSON, TN 37343-4559
(423) 842-1050
(423) 842-7246
Mailing address
435 VALLEYBROOK RD, HIXSON, TN 37343-3067
(423) 842-1050
(423) 842-7246

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0001030
TN
152W00000X
Optometrist
OPT001085
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0068706
BLUECROSS BLUESHIEL OF TN
TN
01
702024767
CARITEN
TN
Enumeration date
01/08/2007
Last updated
02/27/2012
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