Individual
BRIAN T PERKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2253 W MASON ST STE 100, GREEN BAY, WI 54303-4706
(920) 327-7000
(920) 327-7005
Mailing address
164 N BROADWAY, GREEN BAY, WI 54303-2728
(920) 490-9046
(920) 327-7005
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
30965
WI
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
30965
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31603100
—
WI
Enumeration date
07/20/2006
Last updated
04/07/2022
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