Healthcare Provider Details

I. General information

NPI: 1568492536
Provider Name (Legal Business Name): PHILIP S. PERRET, M.D., APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 W SAINT MARY BLVD
LAFAYETTE LA
70506-3538
US

IV. Provider business mailing address

614 W SAINT MARY BLVD
LAFAYETTE LA
70506-3538
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-6435
  • Fax: 337-232-0152
Mailing address:
  • Phone: 337-232-6435
  • Fax: 337-232-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4507R
License Number StateLA

VIII. Authorized Official

Name: DR. PHILIP S. PERRET
Title or Position: PRESIDENT
Credential: M.D.
Phone: 337-232-6435