Healthcare Provider Details

I. General information

NPI: 1639445513
Provider Name (Legal Business Name): DR. JOHN PERPICH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3991 DUTCHMANS LN
LOUISVILLE KY
40207-4700
US

IV. Provider business mailing address

3991 DUTCHMANS LN
LOUISVILLE KY
40207-4700
US

V. Phone/Fax

Practice location:
  • Phone: 502-899-3366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number015730
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: