MEDICARE: DOUGLAS R PERRYMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	R7N89	MO

General Provider Information

NPI Number	:	1033101308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS R PERRYMAN MD

Provider Business Mailing Address
First Line	:	4400 BROADWAY STE 302
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3342
Country	:	US
Telephone Number	:	816-931-9344
Fax Number	:	816-931-4168

Provider Business Practice Location Address
First Line	:	4400 BROADWAY STE 302
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3342
Country	:	US
Telephone Number	:	816-931-9344
Fax Number	:	816-931-4168

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	08/28/2019

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