Individual
DR. SAMUEL E PERKINS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 S 18TH ST, SUITE 104, FERNANDINA BEACH, FL 32034-4733
(904) 277-3277
(904) 277-3611
Mailing address
11945 SAN JOSE BLVD., BLDG 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 399-1717
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
046209
GA
208600000X
Surgery Physician
Primary
ME 98802
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000960242A
—
GA
05
—
278432700
—
FL
01
—
310129
AVMED
FL
01
—
7621418
AETNA
FL
01
—
78270
BCBS
FL
01
—
8997131
CIGNA
FL
Enumeration date
01/23/2007
Last updated
12/27/2017
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