| Doctor Name: | THEODIS PERKINS |
| NPI Number: | 1053380527 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 1193 |
| Business Practice Address: | 13555 W Mcdowell Rd Suite 101 Goodyear, AZ - 853952624 |
| Business Phone Number: | 6239354700 |
| Business Fax Number: | 6239354707 |
| Mailing Address: | 9250 N 3rd St, Suite 4010 PHOENIX |
| State: | AZ |
| Postal Code: | 850202437 |
| Phone Number: | 6026333848 |
| Fax Number: | 6026333841 |
| NPI Enumeration Date: | 03/16/2006 |
| NPI Last Update Date: | 02/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1193 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |