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NPI Code Detail

MEDICARE: DR. LOUIS ANTHONY PERROTT PH.D.

MEDICARE: DR. LOUIS ANTHONY PERROTT PH.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
1103TC0700XClinical Psychologist0810000857VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000663OTHERVAVALUE OPTIONS
263781OTHERVACIGNA
3080252OTHERVAANTHEM

General Provider Information

NPI Number : 1326090580
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUIS ANTHONY PERROTT PH.D.
Provider Business Mailing Address
First Line : 3635 MANASSAS DR
Second Line :
City : ROANOKE
State : VA
Zip : 24018-4031
Country : US
Telephone Number : 540-989-8896
Fax Number : 540-989-8893
Provider Business Practice Location Address
First Line : 3635 MANASSAS DR
Second Line :
City : ROANOKE
State : VA
Zip : 24018-4031
Country : US
Telephone Number : 540-989-8896
Fax Number : 540-989-8893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 09/15/2010

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