Individual
MRS. ELIZABETH ANN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1690 SKYLYN DR STE 300A, SPARTANBURG, SC 29307-1022
(864) 342-4000
(864) 585-2488
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4163
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4819PA
—
SC
01
—
SCL4975019
MEDICARE PIN
SC
Enumeration date
10/11/2021
Last updated
08/06/2024
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