Healthcare Provider Details

I. General information

NPI: 1073674875
Provider Name (Legal Business Name): JOEL EVAN PERCHIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 WOLF RIVER BLVD STE 200
GERMANTOWN TN
38138-1788
US

IV. Provider business mailing address

7600 WOLF RIVER BLVD STE 200
GERMANTOWN TN
38138-1788
US

V. Phone/Fax

Practice location:
  • Phone: 901-747-1007
  • Fax: 901-531-7199
Mailing address:
  • Phone: 901-747-1007
  • Fax: 901-531-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20757
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR-4479
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number13366
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberR-4479
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number20757
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number13366
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: