MEDICARE: MR. JOHN FRANCIS PERRY III 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
1	207X00000X	Orthopaedic Surgery Physician	MD013614E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50026603	OTHER	PA	CAPITAL BLUE CROSS
2	0025993000	OTHER	PA	KEYSTONE HEALTH PLAN EST
3	2063128	OTHER	PA	AETNA US HEALTHCARE

General Provider Information

NPI Number	:	1336221381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN FRANCIS PERRY III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 210
Second Line	:	25 SOUTH PINE STREET
City	:	ELVERSON
State	:	PA
Zip	:	19520-0210
Country	:	US
Telephone Number	:	610-286-1660
Fax Number	:	610-286-1662

Provider Business Practice Location Address
First Line	:	25 S PINE ST
Second Line	:
City	:	ELVERSON
State	:	PA
Zip	:	19520-9720
Country	:	US
Telephone Number	:	610-286-1660
Fax Number	:	610-286-1662

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/10/2010

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