Individual
LARRY ELBERT PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20405 ALBERTA ST, ONEIDA, TN 37841-3509
(423) 569-8840
(423) 569-2533
Mailing address
PO BOX 5118, ONEIDA, TN 37841-5118
(423) 569-8840
(423) 569-2533
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
35454
KY
208D00000X
General Practice Physician
Primary
MD0000031532
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3061062
—
TN
05
—
64799612
—
KY
Enumeration date
07/26/2006
Last updated
07/08/2007
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