# AIXSA PEREZ M D P C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134414329
- **Authorized official:** AIXSA PEREZ M D (OWNER)
- **Authorized official phone:** (574) 675-9630

## Contact information

- **Practice address:** 1712 LINCOLNWAY W, SUITE A, OSCEOLA, IN 46561-1933
- **Practice address phone:** (574) 675-9630
- **Mailing address:** 1712 LINCOLNWAY W, SUITE A, OSCEOLA, IN 46561-1933
- **Mailing address phone:** (574) 675-9630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01049434A | IN | Yes |

## Other

- **Enumeration date:** 06/15/2011
- **Last updated:** 06/15/2011