Provider Demographics
NPI:1861568339
Name:PERRINS, LEIGHTON S (MD)
Entity type:Individual
Prefix:
First Name:LEIGHTON
Middle Name:S
Last Name:PERRINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4088
Practice Address - Fax:215-612-4323
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044178E207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012463820005Medicaid
PA0012463820006Medicaid
PA01246382-04OtherAMERICHOICE BC
PA01246382-05OtherAMERICHOICE FF
PA0516459000OtherKEYSTONE, IBC
PA30567OtherHEALTH PART FB
PA32888OtherHEATL PART PM
PA0012463820007Medicaid
PA01246382-06OtherAMERICHOICE TC
PA6012223OtherCIGNA
PA680028OtherHIGHMARK BLUE SHIELD
PA01697OtherHEALTH PART TC
PA30563OtherHEALTH PART FF
PA3056444OtherAETNA CONTRACT
PA30006084OtherKEYSTONE MERCY
PA680028OtherPERSONAL CHOICE
PA0012463820005Medicaid
PA680028RDBMedicare PIN