NPIMap

Camille Perkins, M.D.

Individual provider Active NPI Pediatrics Physician · Lake Providence, LA

NPI 1073595153 · NPPES record last updated Oct 16, 2019

Key facts

NPI
1073595153
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
109044R (LA)
Practice address
326 N Hood St
Lake Providence, LA 71254-2140
Phone
(318) 559-4900
Fax
(318) 559-1772
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
109044RLAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carroll Parish Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: camille.perkins.1@11988.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 109044R LA Yes

Addresses

Primary practice location

326 N Hood St
Lake Providence, LA 71254-2140

Mailing address

326 N Hood St
Lake Providence, LA 71254-2140
Phone (318) 559-4900

Other identifiers

IdentifierTypeStateIssuer
L09044ROtherLASTATE LICENSE
1926639MedicaidLA

Other providers in Lake Providence, LA

All providers in Lake Providence, LA · Pediatrics Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.