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NPI Code Detail

MEDICARE: DR. DOUGLAS ADAM PERRY M.D.

MEDICARE: DR. DOUGLAS ADAM PERRY 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 Physician040753GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3650896OTHERGABCBS

General Provider Information

NPI Number : 1306844121
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS ADAM PERRY M.D.
Provider Business Mailing Address
First Line : 89 INTERCHANGE DR
Second Line :
City : RICHMOND HILL
State : GA
Zip : 31324-7661
Country : US
Telephone Number : 912-527-5301
Fax Number : 912-756-4740
Provider Business Practice Location Address
First Line : 89 INTERCHANGE DR
Second Line :
City : RICHMOND HILL
State : GA
Zip : 31324-7661
Country : US
Telephone Number : 912-527-5301
Fax Number : 912-756-4740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 02/10/2015

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