Individual
DR. JOHNNY PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
604 N ACADIA ROAD STE 406, THIBODAUX, LA 70301-4897
(985) 446-2524
Mailing address
604 N ACADIA ROAD STE 406, THIBODAUX, LA 70301-4897
(985) 446-2524
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15745R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1465534
—
LA
Enumeration date
10/11/2005
Last updated
10/30/2009
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