Individual
DR. JOHN E PERCHALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
HWY 191 AND HOSPITAL ROAD, CHINLE COMPREHENSIVE HEALTH CARE CENTER, CHINLE, AZ 86503
(928) 674-7166
(928) 674-7705
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7166
(928) 674-7705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35068168
OH
207Q00000X
Family Medicine Physician
Primary
42798
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0138872
—
OH
01
—
080112518
RR MEDICARE
OH
Enumeration date
11/08/2005
Last updated
03/04/2011
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