Provider Demographics
NPI:1598731267
Name:PERRY, BILLY B (MD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:B
Last Name:PERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 W 121ST ST
Mailing Address - Street 2:STE 350
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2002
Mailing Address - Country:US
Mailing Address - Phone:913-948-8365
Mailing Address - Fax:913-541-1034
Practice Address - Street 1:6740 W 121ST ST STE 350
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2002
Practice Address - Country:US
Practice Address - Phone:913-948-8365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002010590208800000X
KS5568208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00300244OtherRAILROAD MEDICARE
MO207186008Medicaid
KS200332590BMedicaid
MO463E044AMedicare PIN
KS463E044BMedicare PIN
KS200332590BMedicaid