Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 125066634 | IL |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 04-44928 | KS |
NPI | 1184010084 |
---|---|
Provider Name | Dr. Michael Wilson Perry |
First Address | Kansas City, KS 66160-0001 |
Second Address | Overland Park, KS 66211-1285 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 13/09/2021 |