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NPI Code Detail

MEDICARE: JAMES D. PERRY DO

MEDICARE: JAMES D. PERRY DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician2834WV
2207RC0200XCritical Care Medicine (Internal Medicine) Physician2834WV

General Provider Information

NPI Number : 1679893036
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES D. PERRY DO
Provider Business Mailing Address
First Line : 4619 KANAWHA AVE SW
Second Line :
City : SOUTH CHARLESTON
State : WV
Zip : 25309-1319
Country : US
Telephone Number : 304-400-4545
Fax Number : 304-400-4546
Provider Business Practice Location Address
First Line : 4619 KANAWHA AVE SW
Second Line :
City : SOUTH CHARLESTON
State : WV
Zip : 25309-1319
Country : US
Telephone Number : 304-400-4545
Fax Number : 304-400-4546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2010
Last Update Date : 02/05/2021

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