Individual
MR. EDWIN PEREZ-LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
83 WELLNESS WAY STE 101&201, BENTON, KY 42025-7156
(270) 527-0045
(270) 527-9615
Mailing address
83 WELLNESS WAY STE 101&201, BENTON, KY 42025-7156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39144
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64106602
—
KY
Enumeration date
07/24/2006
Last updated
12/04/2023
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