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NPI Code Detail

MEDICARE: DR. NATHAN PERRY JR. M.D.

MEDICARE:  DR. NATHAN  PERRY JR. M.D.
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
1207R00000XInternal Medicine PhysicianME61123FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073613295
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN PERRY JR. M.D.
Provider Business Mailing Address
First Line : 1301 MONUMENT RD
Second Line : SUITE 21
City : JACKSONVILLE
State : FL
Zip : 32225-7407
Country : US
Telephone Number : 904-724-9334
Fax Number : 904-725-3120
Provider Business Practice Location Address
First Line : 1301 MONUMENT RD
Second Line : SUITE 21
City : JACKSONVILLE
State : FL
Zip : 32225-7407
Country : US
Telephone Number : 904-724-9334
Fax Number : 904-725-3120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 07/08/2007

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Directions to “ DR. NATHAN PERRY JR. M.D.” Practice Location

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