Provider Demographics
NPI:1710933064
Name:PERRY, ANTHONY (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 HARVARD AVE
Mailing Address - Street 2:STE. 2B
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1172
Mailing Address - Country:US
Mailing Address - Phone:504-454-3004
Mailing Address - Fax:504-454-3075
Practice Address - Street 1:2520 HARVARD AVE
Practice Address - Street 2:STE. 2B
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1172
Practice Address - Country:US
Practice Address - Phone:504-454-3004
Practice Address - Fax:504-454-3075
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD.238R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1545333Medicaid
LA1545333Medicaid
LA5A994Medicare PIN