# KENNETH G.PERRY JR., M.D P.A

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

## Provider details

- **NPI number:** 1316003114
- **Authorized official:** NICOLE YOUNKINS (QUALITY ASSURANCE)
- **Authorized official phone:** (601) 944-1717

## Contact information

- **Practice address:** 501 MARSHALL ST, STE 505, JACKSON, MS 39202-1651
- **Practice address phone:** (601) 944-1717
- **Mailing address:** PO BOX 24023, JACKSON, MS 39225-4023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | 10729 | MS | Yes |

## Other

- **Enumeration date:** 12/28/2006
- **Last updated:** 12/14/2007