Individual
DR. PERRI PRELLOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4809 AMBASSADOR CAFFERY PKWY, SUITE 100, LAFAYETTE, LA 70508-8800
(337) 769-8660
(337) 769-8661
Mailing address
4809 AMBASSADOR CAFFERY PKWY, SUITE 100, LAFAYETTE, LA 70508-8800
(337) 769-8660
(337) 769-8661
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
200736
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043257
—
LA
01
—
200736
LOUISIANA MEDICAL LICENSE
LA
01
—
329548ZLAC
MEDICARE GROUP MEMBER PTAN FOR ACADIANA RADIATION THERAPY, LLC
LA
01
—
4K170DX68
PERRI PRELLOP MEDICARE PTAN EFFECTIVE 05/19/2012
LA
01
—
5DX68
ONCOLOGICS LLC GROUP MEDICARE PTAN EFFECTIVE 05/19/2012
LA
Enumeration date
06/12/2006
Last updated
02/23/2016
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