Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35060176 | OH |
Y | 2080P0204X | Pediatric Emergency Doctor | 35060176 | OH |
NPI | 1114928033 |
---|---|
Provider Name | Jan E. Perry |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 12/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0807452 | (05) | OH |