Provider Demographics
NPI:1467133066
Name:RONALD G PERRY, MD
Entity Type:Organization
Organization Name:RONALD G PERRY, MD
Other - Org Name:RONALD G PERRY, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER / MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUYEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:JULIUSBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:808-206-6456
Mailing Address - Street 1:1314 S KING ST STE 1151
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1945
Mailing Address - Country:US
Mailing Address - Phone:808-946-4541
Mailing Address - Fax:
Practice Address - Street 1:1314 S KING ST STE 1151
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1945
Practice Address - Country:US
Practice Address - Phone:808-946-4541
Practice Address - Fax:808-946-8088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RONALD G PERRY, MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-26
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization