Provider Demographics
NPI:1013297852
Name:PERRY, ANTHONY VINCENT (OD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:VINCENT
Last Name:PERRY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1764 GALLATIN PIKE N
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2122
Mailing Address - Country:US
Mailing Address - Phone:615-865-6074
Mailing Address - Fax:615-865-8470
Practice Address - Street 1:1764 GALLATIN PIKE N
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2122
Practice Address - Country:US
Practice Address - Phone:615-865-6074
Practice Address - Fax:615-865-8470
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN3004152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist