Individual
PHIL C PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 SHIRCLIFF WAY, SUITE 1302, JACKSONVILLE, FL 32204-4748
(904) 308-7420
Mailing address
5102 YACHT CLUB RD, JACKSONVILLE, FL 32210-8324
(904) 387-5163
(904) 387-5651
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME46225
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00427215A
—
GA
05
—
041595200
—
FL
01
—
15980
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/13/2005
Last updated
03/10/2011
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