Healthcare Provider Details

I. General information

NPI: 1538184635
Provider Name (Legal Business Name): WILLIAM BARTON PERRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 01/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 NORTHWOOD DR
CENTRE AL
35960-1022
US

IV. Provider business mailing address

401 NORTHWOOD DR
CENTRE AL
35960-1022
US

V. Phone/Fax

Practice location:
  • Phone: 256-927-3607
  • Fax: 256-927-3606
Mailing address:
  • Phone: 256-927-3607
  • Fax: 256-927-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13352
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: