Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 07000870A | IN |
NPI | 1184730848 |
---|---|
Provider Name | Andrew C Perry |
First Address | Lafayette, IN 47904-2694 |
Second Address | Lafayette, IN 47904-2694 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 21/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U73884 | (02) | IN |