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General NPI Number Information
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NPI Number | 1891766754
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Entity Type | Organization
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Legal Business Name | CLAYTON R PERRY, MD PC
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 11/13/2009
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Provider Practice Location Address
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Address Line | 1011 BOWLES AVE SUITE 400
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City | FENTON
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State | MO
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Zip | 63026-2387
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Country | US
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Telephone | 314-821-4884
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Fax |
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Provider Business Mailing Address
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Address Line | 4248 RELIABLE PARKWAY
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City | CHICAGO
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State | IL
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Zip | 60638
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Country | US
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Telephone | 314-872-1361
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CLAYTON PERRY
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Credential | MD
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Telephone | 314-768-3216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | R3C54
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License Number State | MO
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