Individual
MARK A PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12200 W 110TH ST, OVERLAND PARK, KS 66210-4045
(913) 234-0485
Mailing address
PO BOX 411851, KANSAS CITY, MO 64141-1851
(913) 588-6805
(913) 588-7899
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-23789
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100145720B
—
KS
01
—
18350124
BCBS
—
05
—
202999827
—
MO
Enumeration date
08/20/2006
Last updated
07/24/2014
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