Individual
JOHN W PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 MERCY DR NW STE 101, CANTON, OH 44708-2624
(330) 588-4676
(330) 588-4677
Mailing address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1111
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
23451
SC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35.075387
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000235300
OH MEDICAID UNISON
OH
01
—
2179673
OH MEDICAID MOLINA
OH
05
—
2179673
—
OH
01
—
310917085181
OH MEDICAID CARESOURCE
OH
05
—
3810011193
—
WV
Enumeration date
04/10/2006
Last updated
06/14/2021
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