Provider Demographics
NPI:1750384780
Name:PERRIGIN, JULIE A (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:PERRIGIN
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:PO BOX 778
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37056-0778
Mailing Address - Country:US
Mailing Address - Phone:615-446-0522
Mailing Address - Fax:615-446-4737
Practice Address - Street 1:219 CHURCH ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1303
Practice Address - Country:US
Practice Address - Phone:615-446-0522
Practice Address - Fax:615-446-4737
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4149034OtherBCBS TN PIN
TNQ002040Medicaid
TN4139135OtherBLUE CROSS BLUE SHIELD TN
4036680OtherBCBS TN PIN
TN4271845OtherBCBS TN
080184264OtherRAILROAD MEDICARE PIN
TN4271845OtherBCBS TN
TNQ002040Medicaid