Organization
KENNETH G.PERRY JR., M.D P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE YOUNKINS (QUALITY ASSURANCE)
(601) 944-1717
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, STE 505, JACKSON, MS 39202-1651
(601) 944-1717
Mailing address
PO BOX 24023, JACKSON, MS 39225-4023
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
10729
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02433841
—
MS
Enumeration date
12/28/2006
Last updated
12/14/2007
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