Healthcare Provider Details

I. General information

NPI: 1134222177
Provider Name (Legal Business Name): GUY F PERRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 N POST RD COMMUNITY OCCUPATIONAL HEALTH
INDIANAPOLIS IN
46219
US

IV. Provider business mailing address

1709 N POST RD COMMUNITY OCCUPATIONAL HEALTH
INDIANAPOLIS IN
46219
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-2662
  • Fax: 317-355-3277
Mailing address:
  • Phone: 317-355-2662
  • Fax: 317-355-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01023391A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: