Provider Demographics
NPI:1891752218
Name:LARIMER, PERRY JAMES (MD)
Entity Type:Individual
Prefix:
First Name:PERRY
Middle Name:JAMES
Last Name:LARIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1325 WOLF PARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1742
Mailing Address - Country:US
Mailing Address - Phone:901-252-3411
Mailing Address - Fax:901-384-6422
Practice Address - Street 1:1325 WOLF PARK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1742
Practice Address - Country:US
Practice Address - Phone:901-252-3400
Practice Address - Fax:901-682-0047
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN17493208800000X
MS16135208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3168073Medicaid
382100OtherHEALTH LINK
02110025400OtherQUAL CHOICE
97430OtherBLUE CROSS AR
12940047OtherPHCS
TN0060850OtherBLUE CROSS
4563391OtherAETNA
770391OtherFIRST HEALTH
211159OtherSOTHERN HEALTH SERVICES
2990155OtherCIGNA
12440047OtherHEALTH ASSURANCE EPA
02110025400OtherQUAL CHOICE
97430OtherBLUE CROSS AR