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NPI Code Detail

MEDICARE: DR. BRUCE E. PERRY MD

MEDICARE: DR. BRUCE E. PERRY 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
1207X00000XOrthopaedic Surgery PhysicianMD16305OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11083656367OTHERORCURRY MEDICAL CENTER NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31487696985OTHERORCURRY GENERAL HOSPITAL NPI

General Provider Information

NPI Number : 1396742045
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE E. PERRY MD
Provider Business Mailing Address
First Line : 94220 4TH ST
Second Line :
City : GOLD BEACH
State : OR
Zip : 97444-7756
Country : US
Telephone Number : 541-247-3910
Fax Number : 541-247-3109
Provider Business Practice Location Address
First Line : 94220 4TH ST
Second Line :
City : GOLD BEACH
State : OR
Zip : 97444-7756
Country : US
Telephone Number : 541-247-3910
Fax Number : 541-247-3109
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 06/07/2021

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Directions to “ DR. BRUCE E. PERRY MD” Practice Location

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