Provider Demographics
NPI:1184886269
Name:PERRY, JAMES M (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:PERRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1325 SAN MARCO BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8568
Mailing Address - Country:US
Mailing Address - Phone:904-346-3465
Mailing Address - Fax:904-858-6489
Practice Address - Street 1:1325 SAN MARCO BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8568
Practice Address - Country:US
Practice Address - Phone:904-346-3465
Practice Address - Fax:904-396-0388
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS14123207XS0117X, 207X00000X
COFP4580367207XS0117X
PAOT-012566390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018515100Medicaid
FLIR649ZMedicare PIN