Individual
DR. THOMAS RUSSELL PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5334
Mailing address
2229 15TH ST, MONROE, WI 53566-2116
(608) 325-6664
(608) 299-3745
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
22619
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31804600
—
WI
01
—
569574
DEAN HEALTH PLAN
WI
Enumeration date
11/27/2007
Last updated
05/26/2008
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