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NPI Code Detail

MEDICARE: JAMES L PERRIEN JR. MD

MEDICARE: JAMES L PERRIEN JR. 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
1174400000XSpecialist11818AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151089780OTHERALBLUE CROSS

General Provider Information

NPI Number : 1578554010
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES L PERRIEN JR. MD
Provider Business Mailing Address
First Line : 6701 AIRPORT BLVD
Second Line : SUITE B213
City : MOBILE
State : AL
Zip : 36608-6705
Country : US
Telephone Number : 251-633-3120
Fax Number : 251-633-3115
Provider Business Practice Location Address
First Line : 6701 AIRPORT BLVD
Second Line : SUITE B213
City : MOBILE
State : AL
Zip : 36608-6705
Country : US
Telephone Number : 251-633-3120
Fax Number : 251-633-3115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 01/07/2010

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