Individual
JON E PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1700 N UNION AVE, ROSWELL, NM 88201-3267
(575) 489-4750
(575) 586-4414
Mailing address
714 GARDEN PL, ROSWELL, NM 88201-7767
(575) 489-4750
(575) 586-4414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085-002088
IL
363A00000X
Physician Assistant
Primary
PA2011-0062
NM
363A00000X
Physician Assistant
PA22153
CA
363AM0700X
Medical Physician Assistant
PA-848
ID
Other
Enumeration date
10/05/2006
Last updated
01/02/2020
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