Provider Demographics
NPI:1235431073
Name:JAMES L PERRIEN MD PC
Entity Type:Organization
Organization Name:JAMES L PERRIEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-633-3120
Mailing Address - Street 1:6701 AIRPORT BLVD
Mailing Address - Street 2:SUITE B213
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6705
Mailing Address - Country:US
Mailing Address - Phone:251-633-3120
Mailing Address - Fax:251-633-3115
Practice Address - Street 1:6701 AIRPORT BLVD
Practice Address - Street 2:SUITE B213
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6705
Practice Address - Country:US
Practice Address - Phone:251-633-3120
Practice Address - Fax:251-633-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11818174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC74499Medicare UPIN