Provider Demographics
NPI:1407238173
Name:SOUTH PERRY ENDOSCOPY PLLC
Entity Type:Organization
Organization Name:SOUTH PERRY ENDOSCOPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:GERHARD
Authorized Official - Last Name:PREIKSAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-868-8816
Mailing Address - Street 1:907 S PERRY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3462
Mailing Address - Country:US
Mailing Address - Phone:509-868-8816
Mailing Address - Fax:
Practice Address - Street 1:907 SOUTH PERRY STREET SUITE 203
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202
Practice Address - Country:US
Practice Address - Phone:509-868-8816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 0042906207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty