Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 16280 | SC |
Y | 207W00000X | Ophthalmologist | 27278 | NC |
NPI | 1043213424 |
---|---|
Provider Name | Dr. Thomas C Perraut |
First Address | Columbus, NC 28722-6418 |
Second Address | Columbus, NC 28722-6418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 17/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
66820 | BC/BS OF NORTH CAROLINA (01) | NC |
C85950 | (02) | NC |
C85950 | (02) | SC |
P00394130 | RAILROAD MEDICARE (01) |