Provider Demographics
NPI:1770673683
Name:PERRY, SATIRA T (MD)
Entity Type:Individual
Prefix:MS
First Name:SATIRA
Middle Name:T
Last Name:PERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 JOHNSON ST STE A
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-4537
Mailing Address - Country:US
Mailing Address - Phone:318-574-5080
Mailing Address - Fax:
Practice Address - Street 1:900 JOHNSON ST STE A
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-4537
Practice Address - Country:US
Practice Address - Phone:318-574-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19321207Q00000X
LA336104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine