Provider Demographics
NPI:1326076373
Name:PERINO, LOUIS J (MD, PHD, DVM)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:PERINO
Suffix:
Gender:M
Credentials:MD, PHD, DVM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3400 PORT AU PRINCE PL
Mailing Address - Street 2:
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20189-3400
Mailing Address - Country:US
Mailing Address - Phone:478-787-4879
Mailing Address - Fax:
Practice Address - Street 1:100 PAGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-1600
Practice Address - Country:US
Practice Address - Phone:478-201-4207
Practice Address - Fax:478-201-4205
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056907207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine