Provider Demographics
NPI:1376529479
Name:JULIEN, PERRY HOWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:HOWARD
Last Name:JULIEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5600 ROSWELL RD NE
Mailing Address - Street 2:SUITE M-190
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1150
Mailing Address - Country:US
Mailing Address - Phone:404-255-9131
Mailing Address - Fax:404-255-0731
Practice Address - Street 1:5600 ROSWELL RD NE
Practice Address - Street 2:SUITE M-190
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1150
Practice Address - Country:US
Practice Address - Phone:404-255-9131
Practice Address - Fax:404-255-0731
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000582213ES0000X
GAGA582213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00417337BMedicaid
GA1045280001Medicare NSC