Provider Demographics
NPI:1659989275
Name:JEREMY PERSE, DPM, LLC
Entity Type:Organization
Organization Name:JEREMY PERSE, DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERSE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-284-3077
Mailing Address - Street 1:PO BOX 771545
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-0061
Mailing Address - Country:US
Mailing Address - Phone:216-363-7402
Mailing Address - Fax:216-363-2796
Practice Address - Street 1:2401 SCRANTON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-4313
Practice Address - Country:US
Practice Address - Phone:216-284-3077
Practice Address - Fax:216-331-6834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty