Provider Demographics
NPI:1609962828
Name:PERRIGAN, MICHAEL DALE (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DALE
Last Name:PERRIGAN
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:PO BOX 2929
Mailing Address - Street 2:CROSSVILLE GYNECOLOGY ASSOCIATES PC
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38557-2929
Mailing Address - Country:US
Mailing Address - Phone:931-484-0042
Mailing Address - Fax:931-456-2472
Practice Address - Street 1:73 OLD WEST ADAMS ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-1941
Practice Address - Country:US
Practice Address - Phone:931-484-0042
Practice Address - Fax:931-456-2472
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000016889207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN160057729OtherRAILROAD MEDICARE
TN1609962828OtherNPI MICHAEL PERRIGAN
TNBCBSOther4028476
TN1679784466OtherNPI CROSSVILLE GYNECOLOGY
TN3021328Medicaid
TN160057729OtherRAILROAD MEDICARE
TN1679784466OtherNPI CROSSVILLE GYNECOLOGY